Donald Corenman MD DC | Spine Surgeon Colorado

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goawaysciatica
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April 15, 2012 at 2:43 am

Post count: 5

in reply to: 3 years of sciatica #6019

Thanks again for your help Dr. Corenman. I will show this thread to my doctor when I next go for a meeting and see what he says. You have offered some new ideas for me. Thanks again. Any opinion and insight such as that which you offer on this site is so helpful.

goawaysciatica
Member

April 10, 2012 at 2:22 am

Post count: 5

in reply to: 3 years of sciatica #5992

symptoms:
Variable/changeable over the period since my microdiscectomy (which was November 2010 – 17 months ago)
Pain in lower back. (sciatic) Pain radiating from right buttock through leg thigh, hamstring, groin (occasionally), through calf, permanent pain at the bottom of right foot. (this foot pain was not permanent before the microdiscectomy… it was occasional)
I get ‘minor’ muscle spasms in my leg, often feel cramp in it and generally there is mild pain. The pain is not terrible and is generally bearable. However, it prevents me from exertion or exercise, as this can aggravate it or even cause a relapse. It is restrictive and this is what I would like to fix. I had trained to be a ski instructor and played soccer as well as keeping fit… but have not really been able to do any of this for 3 years now.

average intensity of the pain is currently 1-3 most days, but has probably been up to a 7-8 at worst. I had a bad relapse in August and it has been slowly, but progressively better since then, but I think this is largely because I have ceased any kind of exertion, for fear of relapsing again, as well as having paid for treatments including a steroid injection, physiotherapy and an ablation.

Walking/sitting/lying… I am currently ok with. Pain is always there. not much difference in each… however, walking is better, perhaps because it takes my mind off it… but whilst jogging it begins to return to mind.

I have no x-rays. Might these be a good idea? I have had 3 MRI scans: 1 in 2010 and 2 in 2011.

Thanks.

goawaysciatica
Member

April 7, 2012 at 5:15 am

Post count: 5

in reply to: 3 years of sciatica #5971

Hi Doctor,

Thanks again for replying to my message. This site is very helpful and interesting, with lots of useful information for people such as myself trying to improve back problems.

I found my most recent MRI report and have pasted it below. It is from September 2011 and was taken because I had experienced a strong relapse around 9 months post microdiscectomy. I am inclined to believe that the bulge may have receded a little and improved since then, as overall the pain has lessened and I am more mobile and able than previously and am close to how I was prior to the relapse. (I could be wrong, but this would be my humble guess)

MRI report-

“Findings: . The conus and cauda equine appear normal. There is normal lumbosacral vertebral alignment. No vertebral collapse or focal bone marrow lesion is identified. Disc dehydration with loss of height is present at L5-S1. At this level there is a prominent annular bulge slightly more pronounced on the right side but no obvious nerve root compression. The annular bulge extends into the exit foramina on both sides with contact between the bulging disc and L5 exit nerve root on the right side. Minor bulging is also present at L1-L2 also slightly more prominent on the right side with distortion of the thecal sac and slight compression of the adjacent nerve roots. The exit foramina appear otherwise intact. The articular facet joints appear normal.

Conclusion: Disc bulging at L1/L2 and L5/S1 more pronounced on the right side.”

The trouble is I have residual sciatic symptoms from the microdiscectomy that preceded this relapsed bulge in September and have remained to today, whilst I have largely recovered from the relapse.

This is why I was asking about piriformis syndrome. I have had several expensive treatments to attempt to relieve or solve these problems, but they have remained almost unchanged ever since the op. I was wondering if perhaps they were targeting the wrong thing or had missed something. I accept that piriformis syndrome is probably very rare, so I’m guessing I could be clutching at straws there, but I have already beat the odds of recovery from the microdiscectomy. My surgeon said that this operation had a 90% success rate and I don’t really feel I have come into the successful category.

From the information and suggestions that you gave me, I could fit my symptoms partially into most of them, as described on your site, but perhaps the best fitting one would be lateral recess stenosis. My symptoms are not terrible right now, but have been permanent since the op, with variable pain in my leg & buttock and a permanent pain on the bottom of my foot. My real desire, if achievable, is to get back to being active. I could live with pain if I could get my active life back, but at the moment I am fearful of doing anything too active, in case something happens again.

If you have any thoughts regarding the MRI report, or ideas for treatments that I might try, or investigate I would be very grateful. I have also heard of a company called Regenex that are doing stem cell treatment. I have considered this, but I approach it with caution, as it may be too early stage according to some who I have spoken to.

Many thanks again for your assistance and website.

goawaysciatica
Member

March 31, 2012 at 10:34 am

Post count: 5

in reply to: 3 years of sciatica #5917

Hi Doctor. Thank you so much for your speedy and helpful reply. All information on this issue is so helpful. I will read further around your site and will reply tomorrow as I am trying to fix this problem. Thanks again.
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Viewing 4 posts - 1 through 4 (of 4 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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goawaysciatica

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