Page 4 » Donald Corenman MD DC | Spine Surgeon Colorado

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failedACDF
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January 26, 2015 at 3:13 am

Post count: 30

in reply to: Failed ACDF with 3 different opinions from 3 top surgeons. #12083

Thanks again for your insight.

The instrumentation was only placed on the right side where the laminotomy and foraminotomy were performed. The c5-7 facets were opened just about 50% and then the instrumentation was placed on that side both to help stabilize it, but also because motion was detected in front where the ACDF hadn’t yet fully fused. I assume this added stabilization could make a future ACDF more successful from a fusion perspective?

Interestingly, I did develop the large swelling on the left (opposite side) around the same time as the numbness came back, so perhaps there is a hematoma in the foramen? Does that show on an MRI or does it typically resolve with time?

The thing that still puzzles me is how could I now be worse after this surgery, since I assume if it didn’t work, I would be the same as I was before? Should I give it some more time? Do you think an oral dose of steroids could help? Is it too soon to try a selective nerve root block only 7 weeks after surgery? Also, wouldn’t a nerve root block be temporary at best?

Thanks as always.

failedACDF
Participant

January 26, 2015 at 1:05 am

Post count: 30

in reply to: Failed ACDF with 3 different opinions from 3 top surgeons. #12080

Thanks again for your advice. I would like to ask a few follow up questions if that is ok:

1. Why would the posterior laminotomy/foraminotomy work completely for three weeks and then fail progressively?

2. Also, why would the pain and numbness now be worse than before the surgery, i.e., could the procedure actually make things worse instead of better, even though it was better for a few weeks? I would think that the surgery could perhaps not help, but how could it make things worse?

2. Is it too soon for an MRI? Would you do a CT scan as well?

3. Does the fact that the right side has now had instrumentation placed posteriorly make a potential ACDF more successful to fuse?

4. Did Peyton Manning’s surgery fail because he needed to be fused in front and not just because he had a disc problem that was attempted to be repaired from behind, or was it because of the anterior osteophytes?

Thanks again.

failedACDF
Participant

January 25, 2015 at 11:00 am

Post count: 30

in reply to: Failed ACDF with 3 different opinions from 3 top surgeons. #12073

Sorry for the multiple messages, but the website was rejecting my initial complete message.

In summary, I am now 7 weeks post revision surgery, and the right arm numbness and right shoulderblade pain and numbness that went away completely for the first three weeks after surgery have come back. The arm and hand numbness are worse now than before the second surgery, and the shoulderblade pain and numbness are now almost as bad as before the first surgery. The arm and shoulderblade are made worse by turning my neck even slightly. The arm numbness is also made much worse by laying down with my head elevated and bending my arm at the elbow to read.

I am taking nerve pain medicine, muscle relaxants, and pain medicine. I wear a collar as needed. Surgical pain has improved, but the pain that the surgery was meant to address has now become horrible, after resolving.

I am thinking that this second surgery has now failed, but am baffled as to how it worked completely for three weeks, and now things are getting rapidly and progressively worse. I have been very careful and have no clue what may be happening. I appreciate any insight that you might have.

Thanks

failedACDF
Participant

January 25, 2015 at 10:51 am

Post count: 30

in reply to: Failed ACDF with 3 different opinions from 3 top surgeons. #12072

After surgery, my right arm and right shoulderblade pain and numbness were completely gone. Three weeks after surgery, my right arm started getting numb again, and a week later spread to the hand. Prior to surgery, my right middle finger was numb and now it is the right thumb. The lump on the left is still there and painful. Six week X-rays showed no abnormalities. In the last week my right shoulderblade has once again become very numb and painful.

failedACDF
Participant

January 25, 2015 at 10:36 am

Post count: 30

in reply to: Failed ACDF with 3 different opinions from 3 top surgeons. #12070

Hi Dr. Corenman,

I wanted to update you on my situation.

On December 9th I had a laminotomy and foraminotomy performed at c5-7 on the right side only. The surgeon detected some motion from my prior ACDF so he fused my spine posteriorly using typical screws and rod and autografts using my own bone. No steroids were injected into the nerves during surgery, but I was on steroids for a few days after surgery. The surgery was not through tubes, but was open surgery. Two weeks after surgery, I developed a large golf ball size lump on the left side, which was the side opposite the surgery. An ultrasound showed it was not a hematoma, but a possible muscle spasm. It is still there and painful.

failedACDF
Participant

October 30, 2014 at 9:10 pm

Post count: 30

in reply to: Failed ACDF with 3 different opinions from 3 top surgeons. #11633

Thank you again; I will definitely keep you posted.
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Viewing 6 posts - 19 through 24 (of 29 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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failedACDF

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