Page 5 » Donald Corenman MD DC | Spine Surgeon Colorado

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exercise453
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March 19, 2013 at 1:08 am

Post count: 53

in reply to: assorted cervical questions #8216

Dear Doctor

I anticipate a new mri, both cervical and thoracic. Two years ago the mri was done at a stand alone imaging center, an outpatient extension of a local hospital. It was1.5 tesla I believe to be adequate and an adequate facility. Many spine surgeons recommend a facility they affiliate with and most are tesla 1.5. It is an easy matter to go back to the same facility, more difficult to uncover a facility using 3.0 that is on the insurance. They seem to be few and far between.

1- Is a tesla 1.5 mri adequate or do you recommend going through whatever is necessary for a 3.0??? (You did mention your clinic has 3.0)

2- On the website you say that you can go back to doing most anything after a single level fusion but a two level carries greater restrictions and a three level even greater than that. Can you provide some specifics, especially regarding activities, sports and general daily lifting. What is this life.???

3- Is the choice of using cadaver bone for multi-level fusion still the same as single level. I have read that two and certainly three levels begin to require your own bone???

Thank you

exercise453
Member

February 3, 2013 at 11:25 pm

Post count: 53

in reply to: assorted cervical questions #7898

P.S.

Of course I do not believe this although I sure do want to. It sure would be nice!

exercise453
Member

February 3, 2013 at 11:14 pm

Post count: 53

in reply to: assorted cervical questions #7896

Dear Doctor,

We see a procedure called accurascope by one of these “spine centers”. A cervical procedure places dye and a thin wand into a herniated disc under fluoroscopy and a laser shrinks and seals the disc, shrinking the herniation off the nerve. They put on a band-aid and you go dancing (so to speak). It surely looks like the way things should be treated in the 21st century.

They do make a valid point in their literature where they claim to offer 30 treatments/procedures. They state that doctors diagnose whether the procedures they perform fits versus what is the very best or newest treatment out there. Sadly I believe this to be spot on.

What about this type of procedure to reach and eliminate some herniations as alternatives to acdf and foraminotomy??? Is it a viable alternative or is it flawed and steer clear in your TRUSTED opinion???

Thanks.

exercise453
Member

January 28, 2013 at 4:13 am

Post count: 53

in reply to: assorted cervical questions #7838

Dear Doctor,

I did not understand your answer about surgery on a compressed c4 nerve root if you knew the compression was 7 years old and the symptoms debilitating. I tried to shape the question to be a yes-no answer and I did see your words within reason. I want to be absolutely certain of your opinion on this because I believe this to be one of my problems and its elimination might make a major difference. It may be the one thing something can be done about and the one thing I might be willing to do. I also believe it to be out in the foramen and I wonder what would happen if the nerve were decompressed. Way back on my c2-3 facet thread I mentioned that there was superb relief on a C3-4 block but a later radiofrequency failed. I cannot help but think the anesthetic may have dripped on the nerve root. I had two mri’s. The first shows some compression. (tesla 1.5). The second a year later unfortunately was an open mri and it is awful (didn’t know better at the time)…but there are some revealing axial cuts that show the disc at c3-4 sitting on 95% of that nerve like a boulder on an ant.

So…if this was a simple (for you) foraminotomy would you perform surgery if you knew it was a debilitating sensory c4 radiculopathy that was traumatically induced (weight lifting/fall while jogging) 7 years ago or is it simply too late for any rational hopes of recovery of that nerve???

No response necessary here. Thought you might find this interesting. We went back and forth on the c2-3 facet thread and also the cervical trigger point thread about “the thing” near c3-4 that I am always pressing and also some atrophy (prior to any radiofrequency). One doctor called it a calcification and your last words were puzzle. I think I know what it might be. I think it is a neuroma, one of the small posterior muscles innervated by c4 (longissumus or semispinalis capitus….or a muscle in that area). Am I paying attention or what. 

Thank you

exercise453
Member

December 13, 2012 at 2:04 am

Post count: 53

in reply to: cervical trigger points #7588

One other tidbit…many times as I press and massage the thing and move my head in different positions I feel tingling in and around the ear…one doc said it was a nerve ending

exercise453
Member

December 13, 2012 at 12:55 am

Post count: 53

in reply to: cervical trigger points #7587

Dear Doctor,
This could have been placed on my c2-3 facet thread. To refresh last year I had relief with a c3-4 block, no relief two weeks later with a c3-4 c4-5 block and minimal relief from an eventual c3-8 radiofrequency. Months later there was excellent relief from a c2-3 block and none from a c2-3 radiofrequency.

On this thread I asked about a “thing” right above the c2-3 facet. It is a corn kernel-grain of rice size, hard, irregular, sharp thing that I am forever pressing. After deflating on and all around it, the tender area deflates down to the rocky thing, but the painful thing itself always remains and the area re-inflates.

A new PM doctor (with little to offer) said it was a calcification and there was nothing he could do about it. He does radiofrequencies but not c2-3 and does not do snrb’s so he gave me an interarticular facet joint injection (c2-5). I did not think it could possibly work for a 6 year old condition but the facets had never been injected with steroid so I “took a shot” Two weeks out it certainly has done nothing…(he said it would take a month).

I’ve asked you previously why the blocks worked and the radiofrequencies did not and we’ve discussed that enough, yet I pursue pm because something in that area responded to anesthetic. I now believe it may have been the effect of any anesthetic on the “thing” that quieted it, sometimes for a couple of days. In fact after these recent facet injections I felt better for a couple of days before going back to the usual.

I understand this may be covering a deeper pathology below but maybe not. This exquisitely painful, 6 year old “thing” which has a life of its own seems easily accessible and can be easily injected or dry needled, which makes me wonder why the pm doc said there was nothing he could do. You previously used the word “nodule and dealt with on its own”. I don’t know if that is different than calcification.

If it is a “calcification” should I have it injected or dry needled….what would you recommend???

Is it something that might inevitably be surgically removed, it seems so accessible???

Off topic I would like your opinion on long term, almost daily nsaid use (no pre-existing issues with them and blood tests every 4 months). 1200 mg advil…5 or 6 days a week (in addition to 100mg ultram 2×50 and 800 mg neurontin 2×400 ???

Your performance on this forum is unheard of in the annals of mankind…you have no bigger fan or admirer than I…Thanks
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Viewing 6 posts - 25 through 30 (of 46 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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exercise453

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