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george
Participant

January 16, 2021 at 2:20 am

Post count: 10

in reply to: buttock nerve pain post microdiscectomy #33548

After viewing the MRI, my surgeon word were:
“you have a recurrence, but it does not seem a severe compression, in addition the fragment seems to have a tendency to dehydration, so it may shrink over time
if the pain is not so bad, I’d say we should wait.”

What do you think about this approach?
Why the recurrence happened so soon, are there any reasons for this or it just happens?
I’m feeling hopeless right now, it’s like turning back in time with 10 months but now with a larger herniation, which scares me because I’m a very active person, I was skiing, cycling and doing all kind of physical work and activities , that’s the reason why I went for the surgery , to get rid of the pain and to be able to do all this activities again.
What should I understand , that if the pain is not so bad I could live with it? Isn’t there a risk to get worse considering that the herniation is larger than the first time, will I be able to have an active life or,any kind of sudden move or strenouos activity might agravate the situation?

Thank you very much for your time.

george
Participant

January 15, 2021 at 10:46 am

Post count: 10

in reply to: buttock nerve pain post microdiscectomy #33539

Is the risk of reherniation higher after the second surgery or is it the same 10-15%?
Are there any other options in my case?
Could you please shortly explain the term fusion?

george
Participant

January 14, 2021 at 9:20 am

Post count: 10

in reply to: buttock nerve pain post microdiscectomy #33531

Hello Dr. Corenman,

I’m coming back to you with an update of my situation.
I still have sciatic and buttock pain but not as intense as when I’ve send you the first message.
It’s been 6 weeks since I had a microdiscectomy at L5-S1, a few days ago I had a post op MRI (Lumbar spine MRI without contrast) and here is the result(I had to use a web translator, there might be mistakes ,hope you will understand):
Native MRI examination of the lumbar spine reveals:

-postop status for left paramedian disc herniation L5-S1 left bone edema at the level of adjacent vertebral plates, with a left paramedian hernia recurrence, caudally migrated with maximum dimensions of 10/14/20mm, which compresses the left S1 root.

– diffuse edematous infiltration of the lower lumbar paravertebral muscles

Could you plese tell me what are my options now?

How can you explain that the pain level is lower compared with 2 weeks ago considering that there is a reherniation? For example, 2 weeks ago when I was trying to do the SLR test I could hardly lift my leg because of the buttock pain, now I can lift if to, let’s say 60 degree angle before starting to feel that pain.

In the case of a new surgery , what is the success rate , is that efficient or the risk is even higer than the first time?

Thank you very much.

george
Participant

January 1, 2021 at 5:57 am

Post count: 10

in reply to: buttock nerve pain post microdiscectomy #33508

Hello Dr. Corenman,

I had a microdiscectomy at L5-S1,4 weeks ago, after 8 months since everything started.
The pain I had before the surgery was the most intense in my buttock and the exterior of the hip and less intense down the left leg up to the ankle on the exterior of the calf,and it ocuured mostly when seating and when getting up ,or when bending forward.
Right after the surgery, I was feeling a little bit of pain on the exterior of the calf but not in my bottock, then in the first week post op.the pain was also present in my buttock, at a mild level, not as it was before the surgery, my surgeon told me that is normal if the pain is not very intense.
I started walking outside the house in the following days and the pain got more intense,sometimes greater than before the surgery or comparabale and sometimes it fells a little different than before and on a larger part of my leg, the difference between before and after is that the pain is not so bad when sitting or getting up, but is greater when walking or standing up or even when laying down.
Initial recommendation was to begin kinetotherapy 2 weeks after surgery, buy I informed the surgeon about the pain and he said to not do anything yet.
I took diclofenac and mydocalm for a few days,during this time I felt better, but my concern is that taking this meds I will never know my real level of pain or recovery.
Should I continue to take meds?
If the nerve is not compressed anymore, should I still feel this kind of pain, or shouldn’t that go away little by litlle every day?
Should I wait for the pain to completly go away in order to start any excercises, kinetotherapy?
Is phisiotherapy also indicated?
Is an MRI relevant on this stage of recovery? Would the images reveal the real or actual nerve situation or would that be prevented by the scar tissue?

Thank you very much.
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Viewing 4 posts - 7 through 10 (of 10 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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george

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