Donald Corenman MD DC | Spine Surgeon Colorado

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exercise453
Member

December 31, 2014 at 12:45 am

Post count: 53

in reply to: assorted cervical questions #11932

Hello Dr Corenman,

The following questions are basically 1 question about cervical radiofrequency(RF)and unilateral vs bilateral.
Are most cervical RF unilateral?
If the pain is 100% unilateral is unilateral RF appropriate?
If the pain is 80% unilateral and 20% central is unilateral RF appropriate?
When is Bilateral vs unilateral appropriate?
(The long ago, chronic pain area is C6/7 – T1/2 from an incline bench press accident/injury.

Thank you and happy, healthy holidays and new year.

exercise453
Member

October 24, 2014 at 7:31 am

Post count: 53

in reply to: Cervical pain #11581

Doc Did not understand one thing in your last answer to Kristina76 just above.

If the cervical facet block yields only minimal to mild relief over the next three hours and a CT scan shows “significant bony damage to the facets” does that mean go ahead and have the rhizotomy or do not have the rhizotomy.

Thanks as always

exercise453
Member

September 4, 2014 at 4:59 am

Post count: 53

in reply to: c2-3 facet #11379

One more thought as to whether to go again. If the c2-4 block is repeated it would add c4-5 which has been noted as a pain generator by a prominent surgeon (no weakness) and is the worst looking of all levels on MRI. It is possible that pain from this adjacent level diminished or prohibited benefit from the block. I do not know but as all the lidocaine blocks I’ve had in the past I get a few days of relief in the treated levels. So today the c2-3 and c3-4 levels are quiet revealing the painful, uncomfortable left c4-5. Same question as above.

exercise453
Member

September 4, 2014 at 12:05 am

Post count: 53

in reply to: c2-3 facet #11378

So I finally had the c2-3, c3-4 diagnostic block. (lidocaine + a little steroid). The block produced little to no pain relief.

The office kept me 45 minutes checking in periodically. Levels never went below 31/2-4. They started at 41/2-5. The level never went below 3-31/2, (rarely goes lower) in the next few hours and the pain was easily replicated by tilting or turning left or right and back and circular.

To refresh there was a weight lifting and a jogging fall 9 years back. 3 years ago I had a c3-8 radiofrequency with mild relief and it revealed pain above that as well. 2 months later I had a c2-3 marcaine block. THERE WAS NEARLY 100% RELIEF. After the subsequent radiofrequency I felt great for a month. Then I was hit in the rear while stopped at a traffic light. It was a minor jolt…(I needed a new bumper). Within a week or so symptoms returned. I never believed it was the jolt and that the procedures were just short lived but I do not really know.

For near 2 years I have wanted c2-3 and c3-4 blocked together. And now it has been done but…… There are bulging discs at c3-4 and c4-5, both with “moderate left lateral extension” but I do not think nerve pain is causing the troubling symptoms………..i think the facets are badly degenerated, the discs are degenerated and in certain positions I can reproduce non painful clicking. I thought this failed block was the end of it until the Dr said something strange…..

He said we could try the block one more time with a different anesthetic (marcaine) which still might identify the facets as pain generators. 2 years back when c2-3 was blocked it was with MARCAINE and the relief was nearly 100%. Back then I do remember one other block done with lidocaine and there was no pain relief.

In your opinion can the different anesthetic (marcaine) still identify these facets as pain generators whereas the lidocaine failed to do so??? In your opinion is it worth one more diagnostic block into these painful levels with the different anesthetic???

As always…thanks and gratitude

exercise453
Member

August 19, 2014 at 11:04 pm

Post count: 53

in reply to: c2-3 facet #11298

Dear Doctor,
I must first apologize for having so many threads. With diffuse pain generators and varied causes it somehow just evolved in this disjointed way.

I am scheduled for a left side c2-3, c3-4 medial branch block. The insurance requires only one block. I asked the doctor if it would be a 3-4 hour block. I was surprised when he said “maybe I will do a light block (lidocaine), it is fast acting and we know right away”. When I questioned it he said we could just as well do the long acting (marcaine). You always refer to the longer block with pain diary.

Will the short acting block yield just as accurate results or should I request and do you recommend the longer acting block????

Also the doctor said he would put some steroid for therapeutic value. I had injections of steroid directly into these facets in the past with no benefit at all. Is there a better chance of pain relief when the medicine is injected directly on to the medial branch versus into the facet joint????

And finally will the steroid in any way complicate the accuracy of the diagnosis of this long standing issue???

As always, thanks so much

exercise453
Member

July 24, 2014 at 2:13 am

Post count: 53

in reply to: Cervical pain #11203

Hi Doc,
I anticipate c2-c3 and c3-c4 facet blocks next month. My current PM Doc will not burn the c-2 medial branch because he feels it is too risky but he has no problem pulsing the c-2 level and will do so if the blocks provide the significant relief. He would then burn the nerves below. I do believe this board certified, long time PM doc is both experienced and skilled. Yet some doctors will burn the c-2 level without hesitation. After all the frustrating obstacles from the insurance companies it is depressing choosing between what might be a less effective method or the revolting chore of starting over with another Doc. Also top doctors I would definitely switch to are either not on the network or perform what is done as an in office procedure in expensive surgical centers.

Is there anything at all that makes the radiofrequency burning of the c2-medial branch more risky than those below in your opinion???

Would you recommend waiting and finding a Doc that will burn the c-2 level or would you go ahead with what I have now.???

As always
thanks Doc
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Viewing 6 posts - 1 through 6 (of 46 total)

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Donald Corenman, MD, DC

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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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exercise453

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