Donald Corenman MD DC | Spine Surgeon Colorado

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Germanic27
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October 27, 2017 at 12:07 pm

Post count: 3

in reply to: Degenerative spyndylolisthesis #26710

Dear Dr. Corenman,

Again thank you very much for your rapid response!

You write: “…IF you have truly failed all physical therapy and interventional injections, you need a workup to see if you could be a fusion candidate.”

I’m still at the stage to figure out what ELSE can be done prior any fusion. I was in physical therapy for a while, which didn’t seem to make any difference. Then I went to see my (current) chiropractor, who was able – by “realigning me” – to get the vertebrates/spine “stacked up” in a “correct way”. This treatment was a BIG relief to my situation prior – which was mainly triggered by standing more than 10-15 minutes and which I only can describe as “pressure built in my lower lumbar prior to the “snapping episode” = me losing control of my legs under a hellish pain that I had all summer long. Unfortunately, I had a hernia surgery last week which doesn’t allow my chiropractor to do any new alignment for the next 4-6 weeks. My chiropractor says that he can help me quite a bit if I come on for appr. 30 alignment-visits (first 3x week for 3 months, then 2x week for 2 months and then 1x week). Also, he advised my NOT to do any a excessive core or other workout in order not any other aggravate my spine – but max. do some walking, riding a bike upright at the gym or swimming.

Besides the interventional injections – what other treatment options do I have in your POV prior any fusion? Is there any specific therapy that neither my spine doctor here in LA who ordered the MRI & x-rays (and who btw. didn’t see anything “wrong” on the MRI!), nor my chiropractor so far have recommended? I’m more than willing to do ANYTHING in order to get all options checked prior to any surgery.

Thank you and best,
Nick

Germanic27
Participant

October 26, 2017 at 11:19 am

Post count: 3

in reply to: Degenerative spyndylolisthesis #26695

Dear Dr. Corenman,

Thank you for your quick response – and below please find the MRI report and then X-ray report.

Kind regards,
Nick

MRI REPORT

REASON FOR EXAMN
Low Back Pain

REPORT
History: 51 year old male with low back pain

Technique: Sagittal T1, sagittal T2, sagittal stir, axial T2, and axial proton density images are obtained through the lumbar spine without intravenous gadolinium administration.

FINDINGS:
Lumbar spinal alignement is normal. Mild congenitally shortened pedals are seen diffusely. Diffuse hyperlastic vertebrate bone mare changes are seen with relative hypointense T1 signal. Patient has history of myelofibrosis. T1 and T2 hyper intense lesions are seen at L1, L2 and L4 vertebral bodies compatible with osseous hemangiomas. The largest osseous meningioma 1,9cm in size at L2. Vertebral body heights are intact. No acute fracture or sublimation. Disc desiccation is seen at L3-L4 and L5-S1. Mild disc space narrowing at L5-S1. Posterior annular disc tear is seen at the L5-S1. Conus medullaris terminates at T12. Distal spinal cord signal intensity is normal. Degenerative lumbar spondylosis is seen.

At L1-L2, minimal posterior disc bulge is associated with mild facet joint hypertrophy. No central canal stenosis or neuroforaminal narrowing.

At L2-L3, mild broad-based posterior disc bulge flattens the ventral thecal sac. No central canal stenosis. Mild ligamentum flavor and facet joint hypertrophy. No neuroforminal narrowing bilaterally.

At L3-L4, mild posterior disc bulge is associated with ligamentum flavum and facet joint hypertrophy. No central cana stenosis. Mild leftward neuroforaminal narrowing. No right ward neural foramina narrowing.

At L4-L5, mild posterior disc bulge is associated with bilateral moderate facet joint hypertrophy. No central canal stenosis. No rightward neural foraminal narrowing. Mild leftward neuroforaminal narrowing.

At L5-S1, 3mm broad based posterior disc bulge is associated with moderate facet joint hypertrophy. No central canal stenosis. Bilateral mild lateral recess narrowing.

Abnorma hypointense bone marrow signal consistent with underlying history of myelofibrosis.

Multilevel degenerative disc and joints disease with spondylosis. Posterior annular disc tear at L5-S1. No central canal stenosis or significant neuroforaminal compromise.

Signed by: Kaveh S., MD on 5/23/2017

AND HERE THE X-RAY REPORT FROM 5/12/2017

Cerner Imaging Exam Report
Facility: GA-ASIOC

REPORT: Lumbar spine 3 views

Clinical Indication: Lower back pain, Spondylosis versus fracture.

Comparison: None

Finding: No fracture or significant subluxation. No increase or decreased translocation during flexion or extension. There is no suspicious bony mass. Intervertebral disc spaces are within normal limits. Bilateral sacroiliac joints are normal. No central canal or foramina compromise.

Impression: Unremarkable lumbar spine evaluation.

Signed by: James W., MD on 5/12/2017
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Viewing 2 posts - 1 through 2 (of 2 total)

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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Germanic27

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