Page 2 » Donald Corenman MD DC | Spine Surgeon Colorado

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john123
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February 7, 2015 at 2:16 pm

Post count: 30

in reply to: Stand alone ALIF on a male #12160

Thank you again. It sounds like I should go to the surgeon that has the best results with the way their were trained. I know the surgeon that I just met with can perform the surgery with TLIF, but thinks that TLIF is a step below 360. and I agree with you, if he doesn’t like the results he gets with TLIF than he is probably not the right surgeon for TLIF.

I have consulted with 5 surgeons, – one wants to do PLIF, another stand alone ALIF, another 360 with perc screw, another 360 with posterolateral fusion and one other with TLIF. It would be nice if their was some commonality. As a result, I appreciate you putting all of this in laymans terms. Surgeons do not like to explain themselves or ever be questioned. You accept what they want to do or your out.

So PLIF is like doing two microdisectomies on either side and inserting two cages?

Is it that big of a deal to retract two nerve roots?

The reason why I ask is that there is surgeon locally with high ethics that I do trust that performs PLIF; he claims he can get a good result.

In short, I really do not feel comfortable with anyone going through my abdomen. I understand the process and it sounds like most people do rather well, but I am just not an ALIF guy. As a matter of fact, I think it is a short cut for a surgeon to not have to do as much work and leave you with the risks of cutting through the abdomen in addition to running up a higher bill for BNP, vascular surgeon, and more hardware. Perhaps I am a bit jaded.

I would like to leave my guts, arteries and genitals alone. So I am trying to figure out where to go from here, because I really only have one guy that goes through the back that I comfortable with and he does PLIF and not TLIF. He says he likes the angle better ?

So would it be prudent at this point to to find a surgeon that has expertise going through posterior ? Pars comes out, screws go in, fuse verterbrae and gutters and I’m good to go !

john123
Member

February 6, 2015 at 1:07 pm

Post count: 30

in reply to: Stand alone ALIF on a male #12151

Thank you.

I met with my Neurosurgeon again this past week to discuss TLIF instead of 360.

He does feel very adamant that 360 is better to stabilize the spinal column because, as mentioned previously, cage is bigger and he can get better access to disc space. He did however mention, as did you, that pars fracture should be removed and he will use pars bone for posterolateral fusion. He seems to have everything covered; I can’t thank you enough for your guidance.

He believes retracting one nerve root with TLIF and not being able to access disc space well enough will not give me “as good” of a result, but would probably be good enough. I do respect this surgeon. He has the best reputation in my area and has consistently had very good results for over 30 years. I personally have two friends that he did posterior fusions for that are doing very well 10 years later. He has agreed to do either TLIF or 360 when I am ready.

Having said that, 360 fusion will put 8 screws in my L5,S1 and two rods (4 screws through stand alone alif cage and 4 more more posterior with two rods). I know of many surgeons that are using the same technique but it would seem like the two incisions and hardware alone could become a pain generator after all the other pain generators have been removed.

questions

1.) Could screws from stand alone alif device create pain from the front once the bone grows around them ?

2.) Does 8 screws and two rods sound excessive to you for 360 or does it not matter once fusion takes place ?

3.) I have another surgeon that wants to do 360 without built in screws. He will not remove pars fracture and wants to put perc screws in to back me up without gutter fusion ? Any idea why anyone would do this ? Is it suppose to be less invasive ?

4.) I have a grade one spondy with no change after onset of symptoms 4 years ago. How important is O arm for TLIF ?

I believe you have good results because you are precise with your screw placement. I do not believe other surgeons have the same technology. Would you agree ?

In short, my thought pattern is the same as yours. Why would I want to have two incisions with 4 additional screws, and assume the risk of cutting through abdomen in order to put a larger cage in through the front.

I assume that 360 could be favored by a surgeon because there is no nerve root retraction.

Thank you

john123
Member

January 30, 2015 at 2:51 pm

Post count: 30

in reply to: neck muscle spasms misdiagnosis? #12121

Hey, glad you are feeling better!

I live in your area. May I ask who performed your surgery ?

Thank you

John

john123
Member

January 30, 2015 at 2:33 pm

Post count: 30

in reply to: Stand alone ALIF on a male #12120

Also, I know it is a long shot, but do you think that a series of facet injections would help any ? Most of my pain is under control with brace on; I just can’t walk very far at all with the brace off as it becomes very painful and I have to sit down.

I spoke to a pain management Dr. that said I had a small chance of getting back to normal with a series of facet injections at L4,L5 and L5,S1 even with the grade one spondylolisthesis.

Please let me know you thoughts.

john123
Member

January 30, 2015 at 2:20 pm

Post count: 30

in reply to: Stand alone ALIF on a male #12119

I believe I mentioned in an older post to you that I also have a partial labral tear in my left shoulder. I assume I will have to do a great deal of rehab after TLIF surgery because I have been wearing back brace for a long time, i.e. planks, push ups, etc.

If I came to the Steadman clinic would it be possible to have shoulder surgery and back surgery during the same visit ? I would like to get them both over with if possible.

Also, how long before you let you patients fly back home after fusion surgery? Is it Ok to travel after fusion surgery in a car/flight?

Thank you always for your guidance.

John

john123
Member

January 24, 2015 at 3:58 pm

Post count: 30

in reply to: Stand alone ALIF on a male #12051

I assume with a TLIF surgery there would be a low risk of blindness ?

I was also just reading a post from “Novak” on the forum regarding a pars defect. Although my grade one spodylolisthesis is old, my pain seems to be controlled with my brace.

Do you believe it would be worth it to try a bone growth stimulator at this point?

I was just reading that a bone growth stimulator could promote healing of non union fracture and is part of a conservative treatment ?

If so, what kind of bone growth stimulator would you suggest ?

Thank you again !
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Viewing 6 posts - 7 through 12 (of 27 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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john123

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