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Jellyhall
Participant

November 5, 2018 at 9:55 am

Post count: 91

in reply to: Calcified Disc on MRI Scan #29771

Also, is it common for an MRI scan that showed a herniated thoracic disc compressing the cord, for the disc herniation to reduce in size in a repeated scan done over a year later?

Jellyhall
Participant

November 5, 2018 at 9:52 am

Post count: 91

in reply to: Calcified Disc on MRI Scan #29770

Thank you for your reply Dr Corenman.

Could you please explain to me what an ossified disc is, compared with a calcified disc?

Jellyhall
Participant

July 17, 2018 at 3:28 pm

Post count: 91

in reply to: Thoracic Herniated Disc Surgery #28790

I have noticed that I have omitted to tell you that the report also mentions
L2/3: Broad-based disc protrusion that impinges predominantly on the right foramen, with secondary compression of the right L2 nerve root.

Jellyhall
Participant

July 17, 2018 at 3:24 pm

Post count: 91

in reply to: Thoracic Herniated Disc Surgery #28789

The spasms that I experience as I wake up each morning are in both legs and feet, especially my right foot where the big toe sticks up. Sometimes the spasms cause my back to arch up off the bed which causes my neck to bend backwards.

If I am standing when I get these spasms they are in both legs, again causing my right foot to turn sharply inwards and the big toe to stick up. When standing, I also feel them around my abdomen and they often cause me to make a sound as the air is squeezed out of me.

Jellyhall
Participant

July 17, 2018 at 3:16 pm

Post count: 91

in reply to: Thoracic Herniated Disc Surgery #28788

Thank you again Dr Corenman,

My MRI scan report from last July does state that “at L3/4 there is a broad based posterior disc bulging and bilateral hypertrophy of the ligamenta flava are superimposed on a constitutionally narrow central spinal canal (*Does that mean congenitally narrow canal?), with circumferential compression of the theca/cauda as well as asymmetrical copression of the exiting right L4 nerve root.
That doesn’t explain why there is no reflex at the knee and only slight reflex at the ankle though! I definately do have nerve / sciatica type pain in both legs, but in slightly different positions.

The L4/5 and L5/S1 levels are obscurred by artefact from the metal hardware.

The report also mentions at
C2/3: Broad-based left paramedial sagittal post posterolateral disc protrusion without neural impingement
C3/4 and C4/5 Bilaterally patent central spinal canal and foramina, although there is artefact from the metal hardware obscurring the images
C5/6: Broad based bulged disc and bilateral hypertrophy of the Luschka joints with mild bilateral foraminal stenosis and low probability of bilateral impingement on the C6 rootlets.
C6/7: Broad-based bulged disc without secondary neural compromise

T2/3: Broad based posterior disc protrusion with milk bilateral foraminal stenosis and probable bilateral impingement on the T2 rootlets.
Then the three T7/8, T8/9 and T9/10 levels I have told you about.

My spine sounds a bit of a mess!

This morning, I had the neurosurgeon phone me to confirm that the appointment I received a letter about was intended for me and that I should attend. At my appointment the other day, she was surprised when I showed her the letter, and told me not to go unless I was told it was meant for me.
This is for a Nuclear Medicine Bone PET CT Scan. I asked her this morning on the phone if the scan was to check for bone cancer and she said no.
Can you tell me anything about this scan Dr Corenman, and do you use them?
I think I will be injected with a radioactive tracer before the scan.
I am trying to find out what this scan will show them.

It is good to hear that an epidural injection might help me.

Jellyhall
Participant

July 16, 2018 at 4:34 pm

Post count: 91

in reply to: Thoracic Herniated Disc Surgery #28778

Thank you for your speedy reply Dr corenman.

I wonder if damage to my spinal cord that I was told occurred previously before surgery, could still be causing symptoms in my arms now, after the ACDF surgery. I do know that the two levels below my ACDF levels of C3/4 and C4/5, are compressing the nerve roots.

In the past, I have had brisk reflexes in both legs, but this time she couldn’t produce a reflex in my left leg.

I do feel encouraged by your reply that I may not need thoracic surgery, which is something I have hoped for several years. Another symptom that I have that could well be from the thoracic spine is stiffening spasms (Spasticity) every morning in bed as I wake up and begin to move and also when I stand up after sitting for a long time, such as at the cinema.

I wonder if the reason that I have been told about the transthoracic surgery is because the central disc out of the three thoracic discs is to the right, where the upper and lower discs are to the left. Could this make a more invasive surgery be necessary.

Thank you for responding to my questions. I really appreciate it.
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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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Jellyhall

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