Page 3 » Donald Corenman MD DC | Spine Surgeon Colorado

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jayd10033
Participant

May 20, 2022 at 11:29 am

Post count: 79

in reply to: Sciatica following L3-4 XLIF?? #35070

Surgery 2/25. Buttock / leg ache started 3-4 weeks ago.

Below is the detail of the surgery.

INCISION AND EXPOSURE: Following the surgical time-out and radiographic localization utilizing fluoroscopy, which was interpreted intraoperatively by the surgeon, a 25-mm incision was made in a paramedian manner off of the midline and lateral to the pedicles on the left L3 and L4. Electrocautery was utilized to dissect down the lumbar fascia. Digital dissection was utilized to locate the Wiltse plane bilaterally and to palate the L2-3 and L3-4 facet joints.

INSTRUMENATION/SCREW PLACEMENT: Screws were placed utilizing the Globus ExcelsiusGPS robot according to the preoperative computerized plan. Globus headless Creo AMP screws were placed with 6.5 x 45 mm screws placed at all locations. All screws tested satisfactorily with triggered EMG testing and were visualized in both AP and Lateral planes utilizing fluoroscopy. All screws were satisfactory as interpretted intraoperatively by the attending surgeon.

ILIAC CREST BONE MARROW HARVEST: through a separate fascial incision, 5cc of cancellous bone marrow was harvested from the the left iliac crest for fusion purposes and used to impregnate Vitoss Tricalcium Phospate allograft for fusion purposes. Copious irrigation was performed and a layered closure was performed with vicryl and monocryl.

POSTERIOR SPINAL FUSION: Utilizing the retractor blades, the left L3 and L4 medial transverse processes, L3 pars, and the lateral aspect of the left L3-4 facet joint were identified. The posterolateral bony elements were denuded with electrocautery and then decorticated utilizing aggressive currettage. The space was packed with local autogenous bone graft and additional Vitoss with bone marrow aspirate in order to perform posterior spinal fusion posterolaterally at the facet.

POSTERIOR INSTRUMENTATION: A 55 mm rods was placed. Set screws were placed and then finally tightened utilizing torque-limiting screwdriver. The entire construct was then visualized utilizing fluoroscopic imaging in both AP and lateral views and noted to be in appropriate location. In this manner, posterior non-segmental instrumentation was performed.

jayd10033
Participant

April 23, 2022 at 2:23 pm

Post count: 79

in reply to: Pain/Discomfort after Elliptical #35023

Definitely backing off. Is it possible I did real damage causing the pain (should I get an emergency appt and imaging)?

jayd10033
Participant

April 10, 2022 at 6:53 pm

Post count: 79

in reply to: C5-7 ADR #35004

Thank you. The lateral flexion, extension xrays looked perfect. I’ll see if they recommend a CAT scan. MRI is not good with ADR’s if I recall correctly. I’ll keep you posted!

jayd10033
Participant

April 10, 2022 at 1:09 pm

Post count: 79

in reply to: C5-7 ADR #35002

Thanks – so I was at my ortho for a follow-up to my lumbar fusion (all good there for now!) – and mentioned my neck. We took x-rays, they were picture perfect in terms of disc placement. But the ache and some non painful/non-weakness sensation exists in my arm.

I am really nervous (and frustrated) because I went through this whole double disc replacement and now am having issues again.

It’s been about 3 weeks at this point with neck/scapular ache. At this point, unless there is loss of function, there is now way I would consider more surgery, I think I’d rather just live with the discomfort and hope I can learn to ignore it.

What would you advise as next steps? More imaging? Would cortisone help?

Thanks,
J.

jayd10033
Participant

March 2, 2022 at 9:15 am

Post count: 79

in reply to: Abdominal distension after spinal fusion surgery #34929

Hello Doctor – I was scanning the forum for this exact question. As you have read, I am 5 days post XLIF, and while I know there is some normal swelling, seroma, my entire belly also looks a bit bloated an I (like the author of this post) cannot pull my abdomen/belly button inwards to the same extent as pre-surgery.

Does XLIF cause permanent muscle imbalance/weakness like you noted with ALIF? Or is that only if an error has been made? And/Or is it too soon for me to be thinking about anything related to my belly, strength or aesthetics with given I only had surgery on 2/25.

The best way I can describe my abdomen now is “lumpy” :)

jayd10033
Participant

February 28, 2022 at 8:54 am

Post count: 79

in reply to: XLIF – Day 1 #34917

Thanks. The incision is very painful, and any use of my abdominal muscles is as well, which makes it impossible to easily pass a BM. Taking Miralax and Senna and hoping it improves over the next few days.
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Viewing 6 posts - 13 through 18 (of 59 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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jayd10033

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