Donald Corenman MD DC | Spine Surgeon Colorado

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ffwyfe
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July 26, 2013 at 11:56 pm

Post count: 3

in reply to: upcoming TLIF with transitional vertebrae causing issues #9097

depending on the position and activity is what affects the ratio of back to leg pain, if I am bending forward I have more leg pain if I am upright and walking or standing in one position too long I have more lower back pain that radiates up into my thoracic area, but the leg pain is lessened with walking and exacerbated by sitting… I feel like I can’t win unless I am laying down and even then the muscle spasms start and I wake up very, very stiff and go to bed in crazy spasm and burning from my lower back to my legs (left greater than right) I am not taking up any sports I used to be a gym rat but not a high impact sports kinda person I just want to enjoy my kids… I understand that would contribute to significant limitation of my spine but would not fusing the level in between that is already compromised cause added stress to in and lead me into another problem? My job is physically demanding and I am afraid I will be back to square one again….

ffwyfe
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July 26, 2013 at 8:42 am

Post count: 3

in reply to: upcoming TLIF with transitional vertebrae causing issues #9090

There are several factors that are contributing to the decision of proceeding with a fusion, reherniation, instability, and there is significant low back pain in addition to the leg pain and numbness… I did have a couple diagnostic epidural injections which identified both levels as causing pain as well as the MRI and CT, no discograms… I had held out as long as possible on the idea of another surgery ordeal but the pain and limitation involved is affecting my life in multiple aspects: I am an RN and have a very physical job (I am an ER nurse in a very busy ER and lucky for me I have not had to do CPR on anyone in a long period of time), I am a full time student getting my master’s degree and doing clinical rotations in conjunction with going to work is getting wearing on my back and legs, and lastly but most importantly I am also a mother of very active twin boys and it kills me that I cannot do the things I want to do with them, playing at the park running around on the beach, just horsing around like boys do… those are what led me to my decision to proceed… now i just need to know how far involved it should be… single to two level? Will there be compromise of the level in between if the level above and below are fused? Should I just agree with the two level or be adamant on the single level and take my chances? I will include my MRI report if that helps…

FINDINGS: Previously, a transitional vertebra was reported at the
lumbosacral junction suggesting sacralization of L5. The current
study reveals the vertebral bodies to be stable in signal and
alignment.

T12-L1, L1-L2, L2-L3: No disc pathology. The central canal, neural
foramina are patent.

L3-4: Status post left hemilaminectomy. Disc desiccation, large disc protrusion
which is eccentric to the left. Post-contrast images demonstrate
enhancement in the left lateral epidural region suggesting the
presence of scar and/or granulation tissue. Enhancement to the disc
is noted in the left subarticular/foraminal region. The left neural foramen is significantly
stenotic, right patent. Central canal patent.

L4-5: large disc protrusion. No central canal stenosis. Neural
foramina moderately stenotic.

L5-S1: Transitional level with sacralization to L5. The central
canal and neural foramina are patent.
Impression
IMPRESSION:

TRANSITIONAL LEVEL AT THE LUMBOSACRAL JUNCTION THOUGHT TO REFLECT
SACRALIZATION OF L5. BASED UPON THIS, THE CONUS TERMINATES AT THE
UPPER MARGIN OF L1.

STATUS POST LEFT HEMILAMINECTOMY AT L3-4 WITH FINDINGS SUGGESTING
SCAR/GRANULATION TISSUE IN THE LEFT LATERAL EPIDURAL REGION. DISC
PROTRUSION AT L3-4 WHICH IS ECCENTRIC TO THE LEFT, DISC PROTRUSION AT L4-5 ALSO ECCENTRIC TO THE LEFT

Any insight and opinion you can share would be greatly appreciated… all examples given to explain the content of the disc as a jelly donut so in that respect I am concerned that if the two levels surrounding that already herniated disc are fused it would be comparable to putting a jelly donut between two slabs of concrete? or am i mistaken? Thanks for your time
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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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ffwyfe

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