Donald Corenman MD DC | Spine Surgeon Colorado

Forum Replies Created

Viewing 6 posts - 1 through 6 (of 8 total)

1 2 Next

Author

Posts
Casper
Participant

July 4, 2018 at 7:52 am

Post count: 10

in reply to: Thoracic foraminal compression #28680

Thank you for your reply. I don’t know about that rib head lesion, nobody knows, on MRI there are no signs of malignancy, like no bone marrow edema, it is sharp borders, and I don’t have symptoms like that, the symptoms started suddenly on ballet class and never had any pain or disconfort prior to that. I know that synovial cyst are dark on T1, but when I was trying to find which cysts are both hyperintense on T1 and T2, everything I found were this hemorrhagic facet cysts of sudden onset or filled with proteinaceous tissue. Or you think it could be fat pads out od that facet joint? That small lesion on the pedicle 10 is only right side, could this be osteoid osteoma? My neurosurgeon can’t exclude that, it looks really benign. What other small lesion could it be on pedicle? Is there any way to confirm this, like bone scintigraphy or something? Also what do you think about increasing muscle pain when moving arm above head, I have a felling that it puts more tension on the joints, I have muscle guarding contracture level 10 and 11 so I am thinking probsbly that facet joint?

Casper
Participant

July 2, 2018 at 5:14 pm

Post count: 10

in reply to: Thoracic foraminal compression #28668

Thank you for your answer. Yes it is clearly in the foramen and it is a round cystic formation, and really is visible that the spinal nerve t11 right is stuck in that foramen, and I have pain in the t11 dermatome with paresthesia and tingling, also allodynia, radiologist said just fat, nothing, ok, but why fat only in one foramen of all only dat side at that level that I have pain, my neurosurgeon thinks it can be fat from that facet joint (fat pads), but also thinks it maybe synovial cyst, for me is more likely the synovial because it is really round like all the facet cysts and think it could be hemmorhagic, thus hemosiderin not visible on STIR (also because when it was accute in my first MRI they just did T1 and T2), also my age, I am young, other facet joints are not degenerated and I had acute start of symptoms which this hemorrhagic cyst tend to. I don’t have pain in my arm, it is my arm movement above head like washing hair that triggers the pain paravertebral T10-t11, and this happens when I am in severe spasm, so it also puts tension on that area. I am thinking this because of facet joint pain due to secondary osteoarthritis and that cyst, am I right, is the facet joint itself making this spasms? So this facet diagnostic block applied more pressure on it? (I am aware this was only diagnostic that is why I ask is it normal to make symptoms worse?).The edema in cv joint t11 is what I think only extension od edema from facet joint, don’t think it is fracture anymore or it could also be due to secondary OA edema(overuse in ballet). But I don’t know about my CT scan which showed 10th rib subluxation on the right (it is visible on 3d reconstruction with osteopenia of rib head, like a hole in rib head and 10th pedicle, probbably from rubbing), I know it is rear, a lot doctors don’t believe it can happens, but 10 th rib can slipp in slipping rib syndrome, but mine looks a lot rotated and atacched to both 10th and 9th vertebra, not on the left only that right. Could you think it can happen or it can be maybe minor subluxation which appers to be more on CT because of that severe muscle spasm above this facet joint? Because if it is because of spasm, doing some medial branch block and removing the cyst endoscopic could help that level about? He suggested blocking also this 10th cv joint (terapheutic with steroid), but I am affraid of doing more damage because on osteopenia, making the bone damage worse, or maybe doing it but thinking of taking some biphosponates like Alendronat because od it’s affect on bone lesions, regional osteopenia and bone pain not only for osteoporosis. Do you have any experience With this drugs and bone pain? I am dessperate, so I am willing to try anything, also it my help a little with facet pain because it is also used for osteoarthritis pain, reducing bone marrow edema, at least it could not make more damage. Thank you and sorry for such a long report, just want the pain to stop.

Casper
Participant

April 8, 2018 at 8:59 am

Post count: 10

in reply to: Thoracic spine issues #28046

Thank you doctor. To Robin: I had an injury and my rheuma tests are fine, do not have morning stiffnes. I also have this tinggling wrap in my lower ribs. Prp are platelet rich plasma shots, from my blood, and it is a regenerative method for joints. I have MRI scheduled next month.So are you HLAb 27 positive? Do you have also low back pain? I think you should do MRI first so then decide if go to reumathologist or not. Maybe it will show something.

Casper
Participant

April 8, 2018 at 8:49 am

Post count: 10

in reply to: Thoracic spine joints #28045

Thank you for your answers. I know this costovertebral disorders are rare, but can occur in hyperextension ballet injuries. Mine was a sudden twisting and hyperextension injury in ballet. I do not think I have Scheuermman disorder because my symptoms were severe and started after that injury and I don’t have scoliosis. Also my endplates of vertebra look fine on the MRI, no edema,there are not anny degenerative changes in my t and lumbar spine, my discs are great, no degeneration no herniation. Only thing that is changed are this 11th and 12th costovertebral and ct joints, With this bone marrow edema, other joints are just fine. Hoe can this bone marrow edema heal, what to do? The whole joint is White on T2 sequencs. This is the exact point of my pain and it spreads in the front bend like pain. So I think it is radiculopathy.my spine surgeon showed me my 3d ct and it is really 11th rib subluxation in the right side, and the rib head is more in the foramen impinging 11th spinal nerve, and when I move I can feel ot, I feel that nerve irritation, I have intercostal pain. He gave me bupivacain shots in that joints and intercostal nerve and it gave me instant relief. Thank you.

Casper
Participant

April 8, 2018 at 3:05 am

Post count: 10

in reply to: Thoracic spine issues #28039

One more thing. Did you go to reumathologist olso? Do you have morning stiffnes? Did you do rheuma test and gene tests to see If you have HLA B 27 a gene that goes With spondyloarthritis. Because SpA is associsted With abdominal issue. Every back pain that lasts longer than 3 months in young people and With morning stiffnes spondyloarthritis should be ruled out.

Casper
Participant

April 8, 2018 at 2:54 am

Post count: 10

in reply to: Thoracic spine issues #28038

How old are you? I am 29,and have this problem for a year. I have pain on the right side only. My spinous process is not sore, but near it on the right is really sore. First 6 months I had abdominal pain, feeling like I have ruptured my muscle, but then went to osteopat and it helpped. Now I only have t spine and rib pain. Do you take pain medication. For me naproxen works a bit. Nobody believed me that I have small joints issue and rib subluxation, because ribs can’t subluxate. But my CT scan showed it. Everyone told me not to do it because of radition but I knew it will show rib problem. If your MRI would show nothing than consider CT scan because it is better for the bones and joints, MRI is better for neural structures. I have found a good neurosurgeon, private clinic who has experience With t spine. He gave me prp injections in my joints, regenerative method and it helpped but now after 3 months the pain is back. I will do second MRI and then He will give me intercostal nerve blocks and maybe another prp. Your abdominal pain is from lower t spine. But is it like musce pain or you have like intestinal problems or something like that?
Author

Posts

Viewing 6 posts - 1 through 6 (of 8 total)

1 2 Next

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.

Submit your review
First Name, Last Initial:
Email:
Review Title:
Rating:	1 2 3 4 5
Review:

Check this box to confirm you are human.
Submit Cancel

Casper

Forum Replies Created