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BRONCOFAN1
Participant

December 24, 2017 at 8:38 am

Post count: 42

in reply to: Neck and Shoulder Pain #27147

Thanks Dr. Corenman,

I will try to be patient – not my strong suit! Since I had ADRs already at C5-7 I shouldn’t have had any height change with this surgery, but the surgeon did warn in advance that the pain would likely be somewhat worse immediately after surgery as the distraction for removal / insertion of new grafts would stretch the already painful facets somewhat.

In your experience, is the ACDF almost always successful in eliminating the facet pain caused by failed cervical ADRs? It stands to reason that without motion there should be a big improvement.. on the other hand there must still be some load transmitted through the facets at the fused level. Curious if that can cause them to remain painful even after ACDF to any degree? Probably overthinking all of this, as usual :)

Happy Holidays to you and yours!

Kevin

BRONCOFAN1
Participant

December 22, 2017 at 11:06 am

Post count: 42

in reply to: Neck and Shoulder Pain #27106

Hi Dr Corenman,

I had my ACDF revision C5-7 a week ago. For your patients with failed ADRs, how long does it typically take post surgery for the facet pain to go away? I assume it can depend on how irritated the facets were going into the surgery… I was thinking this should take a few weeks at most but wasn’t really sure.

Thanks,
Kevin

BRONCOFAN1
Participant

November 30, 2017 at 8:31 am

Post count: 42

in reply to: Neck and Shoulder Pain #26961

Hi Dr Corenman,

Explantation and revision to ACDF scheduled in a couple of weeks. While there’s no penalty for waiting, I can tell based on the feedback from my neck that there will also be no benefit! Plus the pain is a pretty hefty penalty!

I want to say again that I’d still be spinning my wheels without your help, so thanks so much!

Will let the forum know how it goes, although I may have some questions about the surgical plan after I go over it in details. I’m thinking autograft for sure, beyond that I hear using the shortest titanium plate that works is important for reducing adjacent segment issues. Any other key things you would suggest I ask about for an ADR revision?

Thanks,
Kevin

BRONCOFAN1
Participant

November 28, 2017 at 6:24 pm

Post count: 42

in reply to: Neck and Shoulder Pain #26952

Hi Dr. Corenman,

Subsequent to posting this, I did a little bit of research. A posterior fusion seems like an inferior construct that would leave the non-MRI compatible, and no longer useful, artificial disc in place. It also doesn’t seem like it should be all that difficult to dig out a Mobi-C – it’s going to be 5-6 months old so I’m sure it’s well attached to the bone, but I just really don’t think a posterior fusion is the way to go.

Surgeon thinks I should wait to see if my symptoms improve, but I don’t see the point. With the facets being overloaded, it seems that it would take many years for improvement as you’d need facet bone spurs to restrict motion, with a good chance that relief never occurs in the presence of the permanently mobile ADR and also a good possibility that bone spurring causes additional problems. I certainly have not seen any notable improvement in the 4 months since the surgery, with the exception of some relief from an RFA.

Would appreciate your thoughts as always!

Thanks,
Kevin

BRONCOFAN1
Participant

November 28, 2017 at 2:04 pm

Post count: 42

in reply to: Neck and Shoulder Pain #26951

Hi Dr Corenman,

My surgeon is recommending a posterior fusion instead of attempting to revise these Mobi C devices to an ACDF. How do you feel about that as an option?

Thanks,
Kevin

BRONCOFAN1
Participant

November 25, 2017 at 3:32 pm

Post count: 42

in reply to: Neck and Shoulder Pain #26934

Hi Dr. Corenman,

Well, it appears my RFA pain reduction has peaked.. I had about 30% at 7 days and now at 2.5 weeks it is basically unchanged from that. I will give is some more time but I’m going to dual track the prep for a revision to ACDF at this point. Is it unusual to get such a small amount of pain relief after getting 100% relief from an MBB? I’m hoping the MBB relief is a good indication of what I might achieve with a revision to ACDF in any event. My replaced discs are at c5-7.

Two additional questions for you:

1) my c3-5 discs are normal on MRI and recent surgery follow up x rays show no loss of disc height. Any reason for a new MRI before considering a revision surgery? Also, would you be concerned that the flex ex shows 2 mm of motion at the c3-5 levels between flexion and extension? Seems like that is at the high end of the normal range… just curious if that will put me at more risk for developing problems at these levels after ACDF, or of 2 mm is normal enough to potentially not really mean anything…

2). If I do go with the revision route, are there any necessary activity restrictions with a 2 level ACDF? Was hoping to get back to light jogging and such, and a (perhaps misguided) belief that ADR would be better for future activity weighed heavily on my decision to go that route.

Thanks!
Kevin
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Viewing 6 posts - 19 through 24 (of 41 total)

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Donald Corenman, MD, DC

Average rating:

81 reviews

Eric S

Sep 26, 2021

by Eric S on Donald Corenman, MD, DC

Successful pars repair at 46 years old

Back in November of 2018 (at 46 years old) I came from Vancouver BC to have a pars repair done with Dr. Donald Corenman at the Steadman Clinic in Vail Colorado. I'm finally posting this review nearly three years later in late 2021. The reason I waited so long was I wanted to know the final result before I posted my review. Unfortunately in that time Dr. Corenman has retired. Nevertheless, I want to post this review of Dr. Corenman and his staff at the Steadman Clinic in their excellent treatment of my L5 pars interarticularis.

I fractured my pars at age 42 back in 2014 when rolling on the gym floor, and was denied treatment by the Canadian healthcare system, probably due to my age. First my GP told me there was no surgical option for a pars defect, which was quite incorrect! I tried to live with it, but the symptoms worsened (periodic random spine slippage and weeks of resultant pain after just bending over to tie my shoe, so I eventually learned to mostly squat and hardly bend). When I finally consulted with Canadian spine surgeons, I was told they believed my pars defect had been congenital (since birth). This was absurd, considering I had done extreme martial arts (including jiu jitsu) for years prior, as well as 5 years of reinforcing steel full time in my 20s, probably the hardest job on the back you can find. No pars defect like mine would possibly have allowed this--ergo it was impossible that I had had the defect since birth. I did however have an asymptomatic congenital spina bifida occulta that made me more susceptible to a pars fracture. In 2014 in one instant, I went from having the strongest back people I knew said they'd ever seen, to being unable to safely bend over and tie my shoe without a non-negligible risk of my spine slipping randomly (which would lead to weeks of pain after each occurrence). This was due to the unilateral L5 pars defect, otherwise known as spondylolysis. It was when lying in pain on the floor 4 years later after maybe the 6th spine slippage event post injury, that I had had enough, and resolved to have surgery. If Canada's "universal health care" said no, I would make lemonade from lemons, and find the very best surgeon in the world at pars repairs. That was Dr. Donald Corenman. Dr. Corenman back in 2018 ran a website https://neckandback.com/ that dedicated many pages to the science of every aspect of pars repairs, from eligibility (good discs on MRI), to best surgical techniques (minimal open compared to minimally invasive), best imaging to use (i.e., O-Arm with Stealth imaging vs. older fluoroscopy), the ideal amount of BMP to use and why not use too much or too little, and much more, all to do with pars repairs, pages upon pages of his site just on the pars, with scientific references and his own extensive expert opinion. As a health research statistician, I was very impressed with this. It was in stark contrast to the websites of other spine surgeons which barely gave the pars a word or two, focusing almost exclusively on fusions. I had found the best surgeon in the world for pars repairs, and so after Dr. Corenman personally screened my MRI to ensure my discs were healthy, I booked the surgery.

Being 46 years old at the time of surgery in 2018, with a 4-year-old pars fracture from 2014 combined with a congenital SBO meant my pars fragment was somewhat atrophied, but it was "very solid", said Dr. Corenman in the operative report. Nevertheless, it was challenging with two things to fix, the pars and SBO, and OR time was around 4 hours. Recovery over the following months was guided by a very clear "Spine binder" from the Steadman Clinic with strict rules of "no BLT" (no bending, lifting or twisting), and illustrated physiotherapy guidelines. They even warned patients to avoid fish oil supplements, which could excessively dampen inflammation and hence slow bone healing. They answered many questions I had during months of recovery, with responses coming from the very supportive Lori Fugate (then director of Dr. Corenman's practice), and Ehrich Bean (then physician's assistant at the practice), as well as a couple calls with Dr. Corenman himself after two of the CT scans. Ehrich Bean offered great advice for taking the spine binder conservatively due to the nature of pars repairs vs. fusions. The final post-op CT scan I had was a couple weeks ago at 34 months post-op, and Dr. Corenman had retired, but I got a very positive and informative call from Eric Strauch (current PA at the Steadman Clinic under Dr. Corenman's replacement there, and who had also worked with Dr. Corenman previously). The staff at the Steadman Clinic were extremely supportive all the way through the process. I should mention, the local Canadian spine surgeon did offer me very good post-operative support including antibiotics as needed to deal with a mild surface incision-site infection early on, booking numerous x-rays when I felt something was amiss, as well as booking all four of my post-op CT scans. I am very grateful for that support also.

My final result shows plenty of solid bone across the pars and a healed SBO, with my vertebral body now a solid bone ring instead of being broken at two places as it was pre-op. Does my spine hold up in the real world? You bet! I have recently dug and moved several yards of dirt and sand and gravel by myself (shovel and wheelbarrow!) to fix our water main, pulled roots from the yard, moved several "portable" (these are HUGE) air conditioners up several flights of stairs my myself, and lifted weights. I now run 2 miles (3.2 KM) several times weekly with a hard 100 meter dash in the middle. I bend deeply before each run I go on, with no spine slippage. My spine feels amazing. I can bend over to do exercise, or real word tasks, with no risk of spine slippage.

My sincere thanks to God, Dr. Donald Corenman, Lori Fugate, Ehrich Bean, Eric Strauch, and the Steadman Clinic, as well as the Canadian spine surgeon who offered me excellent post-operative care back in Canada. You have all given me a new lease on life.

Sincerely,
Eric S

Robert S

May 11, 2021

by Robert S on Donald Corenman, MD, DC

Back Fusion Surgery

I had my entire lumbar spine fused in November of 2018. I had scoliosis , with pinched nerves that were so painful I could hardly walk - and standing for more than a few minutes was impossible. Even sitting was painful.
The fusion surgery produced immediate relief! And the recovery was much easier than I expected.
To this day I can do all the activities I love from hiking, to standing in a stream fly fishing to riding my bike long distances - or just walking down the street with my wife.
Kudos to Dr. Corenman and his staff, (including the two Erics) for taking such good care of me!

Leslie R

Jul 9, 2020

by Leslie R on Donald Corenman, MD, DC

TLIF

I had my TLIF surgery on 6/24/2020 by Dr. Corenman, I can not say enough good things about the Dr or his staff. I was always treated with respect and explained everything throughly, that made it easy for everyone to understand. I highly recommend Dr. Corenman and the Steadman Clinic.

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BRONCOFAN1

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