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failedACDF
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February 2, 2015 at 12:27 am

Post count: 30

in reply to: Failed ACDF with 3 different opinions from 3 top surgeons. #12136

Thanks very much. You described it perfectly. Do you think that a 7 day course of oral prednisone scaled from 60 to 40 to 20 mg is enough. For instance would staying on it for a few more days work better, or could that prejudice the success of a posterior fusion?

failedACDF
Participant

February 1, 2015 at 3:23 am

Post count: 30

in reply to: Failed ACDF with 3 different opinions from 3 top surgeons. #12131

Hi Dr. Corenman,

I just wanted to give you a further update. The neurosurgeon started me on prednisone (60mg for 4 days, then 40 mg for 3 days, then 20mg for two days, and it seems to be helping). Hopefully it’s not just temporary. He wants to hold off on the MRI while I am on the prednisone. He then wants to do a CT scan in a few weeks to see how the fusion looks both from the prior ACDF and from this posterior instrumentation. Hopefully the prednisone doesn’t prejudice the fusion from occurring.
Thanks

failedACDF
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February 1, 2015 at 3:22 am

Post count: 30

in reply to: Failed ACDF with 3 different opinions from 3 top surgeons. #12130

Please see below, this went through in error.

failedACDF
Participant

February 1, 2015 at 3:21 am

Post count: 30

in reply to: Failed ACDF with 3 different opinions from 3 top surgeons. #12129

Please see below. This went through in error. Thanks.

failedACDF
Participant

January 27, 2015 at 2:52 am

Post count: 30

in reply to: Failed ACDF with 3 different opinions from 3 top surgeons. #12093

In May I had ACDF at C5-7, but had continuing bad shoulderblade pain and numbness and right arm pain and numbness. After 5 months this area only had a little bit of fusion. So in December, laminoforaminotomy was performed on the right side of C5-7. After that surgery the numbness and pain were completely gone. The numbness returned three weeks after surgery on the right arm, and six weeks after surgery the shoulderblade pain and numbness returned.

The relevant portion of the operating room notes pertaining to the recent surgery state in part:

“The C7 nerve root was identified in the lateral recess and followed out of the foremen and was completely decompressed.

I then worked at the C5-6 level where I was a little broader in terms of the bone removal because this was a tighter area. Again excellent decompression was achieved. C6 nerve root was seen and was nicely pulsatile. There was a small bit of movement between C5-6 and because of the amount of bone resected, I elected to instrument this area.”

The report describes the instrumentation on the right as being screws and a rod and autografts.

Hopefully this clarifies things.

Thanks

failedACDF
Participant

January 26, 2015 at 9:14 pm

Post count: 30

in reply to: Failed ACDF with 3 different opinions from 3 top surgeons. #12091

Thanks again. Instrumentation was placed at all levels (C5-7), but only on the right. I think this was both to stabilize the right and to help the front possibly fuse. My assumption is that it was better to fuse the right, then not fuse from the back at all, if the front was not fusing? Pehaps fusing from both sides posteriorly would have been more invasive. I remember after my ACDF, the MRI showed a lot of shadows. Would an MRI now show a possible foramin hematoma or what may be going on?
Thanks
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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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failedACDF

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