Donald Corenman MD DC | Spine Surgeon Colorado

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kristina76
Participant

November 3, 2016 at 9:06 am

Post count: 8

in reply to: Upper cervical nerve/facet pain #23356

Thank you for that prompt and detailed reply! This forum is so helpful to so many. I have had all of the tests you mentioned, which only shows some minimal facet degeneration, but I still have severe nerve pain and muscle spasms/joints cracking. Maybe it’s more damaged facet nerves/capsules then actual degeneration? The only other question I had was could other nerves be involved that are being missed? I’ve never had any selective nerve root blocks. What is the highest upper cervical nerve root that can be blocked? If I had damage to the upper cervical nerve roots, how would it present differently than damaged medial branches? I don’t have much tingling or loss of motor control, just pinpoint palpable pain at c2 region (like a bad tooth when you press on it), headaches, cracking, spasms, difficulty turning my head left. If a nerve root is blocked and that seems to be some of the pain source, how is that treated? I don’t have visible stenosis or nerve root compression on my recent exams.

kristina76
Participant

November 19, 2014 at 4:57 am

Post count: 8

in reply to: Cervical pain #11758

Hi Dr. Corenman,

So if you respond better to capsular blocks than medial branch blocks, does that offer more information into the diagnosis of the area of pain or require a different treatment than rhizotomy?

Also, if there is degeneration/spurring in the C2-3 facet joint, what are your thoughts on the success/pain relief of having the spurring removed (joint debridement) and performing a rhizotomy? This is the type of procedure I might consider instead of a fusion.

Thanks again for your time,

Kristina

kristina76
Participant

October 24, 2014 at 11:39 pm

Post count: 8

in reply to: Cervical pain #11588

Hi Dr. Corenman,

I hadn’t heard of the intracapsular facet blocks? I know what the capsule is, but didn’t know there was a separate block for it. Is this something most pain physicians perform?

Also, I totally understand what you mean about the term “minimally invasive” and how it can be misused. I just mean that I would like to avoid a fusion and know there are some other options available. Do you have a good surgeon you could recommend near Massachusetts?

Thank you so much!

Kristina

kristina76
Participant

October 17, 2014 at 12:26 am

Post count: 8

in reply to: Cervical pain #11544

Hi Dr. Corenman,

Somehow I missed your response to my last post from a few months ago. Sorry about that!

I haven’t had much relief from facet injections into C2-3, C3-4 (except for one time), but I can tell that they are hitting an area of pain for me when the needle goes in and I have all the symptoms of facet pain- cracking, tenderness to palpation over facets, degeneration on x-rays, can’t turn my head, headaches, severe spasms, etc.. I can literally feel the facets grinding on each other.

Any thoughts on why I may not be responding optimally? I know it’s not disc pain or severe instability. Have you seen anyone who did well with rhizotomy even if they have not responded as expected with the injections?

I had asked you previously about the benefit of Cat Scans. Coming from a surgical stand point, if I were to consider a minimally invasive procedure at some point, would it be of benefit to have a Cat Scan to see if there are bone spurs rubbing on nerves, or foraminal stenosis, or should that have already shown up adequately on my x-rays and MRI?

Is there a minimally invasive surgeon that you could recommend that is close to Mass? I’m having a hard time finding one that isn’t a long distance away. It would be good to have someone thoroughly look at my tests and give me their opinion. Do you ever look at exams and give a consult over phone/email?

Help!! ;)

Thank you,

Kristina

kristina76
Participant

June 27, 2014 at 4:06 am

Post count: 8

in reply to: Cervical pain #11103

Hi Dr. Corenman,

I had contacted you a while back regarding C2-3, C3-4 facet pain. I had received some pain relief with my second cortisone injection, though not complete relief, so this tells me that at least some of my pain is facet related.

I am currently considering the ablation procedure and had a few questions for you.

1. I have heard that the C2-3 facet is a more risky area for ablation, and that it doesn’t have as high a success rate due to involvement of the occipital nerve. Do you find this to be true in your experience?

2. I am a PT and given my anatomy training, I am concerned about nerve damage/worsening pain from the ablation. I know this is rare, but can you give me a ballpark idea of how frequently this occurs? I have heard some people get great relief, and others where it seems like a horror story of worsening nerve pain after the ablation.

3. I also have researched pulsed radiofrequency ablation, where the nerves are stunned instead of burned. This seems like a safer option, but not many doctors in Mass. do this and I have also heard people may not get as good pain relief. What are your thoughts?

4. And finally, I have also read that Cat Scans are best for getting a better view of the facets. I have had multiple x-rays and MRI’s which show some degeneration in the facets, but not bad. I was wondering if it would be beneficial to get a Cat Scan to rule out any bone spurs around the facet joints? I just don’t want to expose myself to extra radiation if it’s not necessary since I’ve had so many tests.

If you don’t mind taking a few minutes to answer these questions, I would greatly appreciate it. I just can’t deal with this nerve pain anymore!!

Thank you,

Kristina Jaeckel

kristina76
Participant

September 26, 2013 at 7:24 am

Post count: 8

in reply to: Cervical pain #9473

Hi Dr. Corenman,

Thank you so much for your thorough reply. As time goes on, I feel my symptoms point more and more to facet syndrome at C2-3, C3-4. I am scheduled for facet injections next week.

My only concern is when I palpate near the C3 facet joint, the pain is nerve-like, kind of like pushing on a toothache. And the pain I have from this area going into my head is stabbing in nature. The area is so hyper sensitive that I have pain with any small movement of my arms or even if I push down on a stationary bike with my legs, I will feel that area in my neck.

My theory is that the nerves surrounding the facet joint are irritated due to the swollen facet, or the medial branch itself is getting pinched at the joint. Because the nerves are inflamed, any contraction of my neck muscles to stabilize my arms or legs is pulling on the inflamed facets/nerves in the region.

Have you seen people with cervical facet syndrome with these type of nerve complaints? The nerve symptoms are what concern me the most as they are hard to pinpoint, treat, don’t respond to pain meds, and cause a lot of pain.

My MRI does not show much degeneration or disc problems, so I am hoping the facet is inflamed, not permanently damaged, and that facet injections may calm the area enough for me to be able to restore normal joint mobility in my cervical spine with treatment and stop the irritation. (I think faulty joint motion that I am currently treating may have cause excessive stress to C2-3 facets) I don’t believe there is nerve entrapment due to scar tissue because I have already treated and addressed that and still have the pain.

What are your thoughts about the nerve irritation and prognosis of pain relief with injections? I’m concerned about the whole chronic pain cycle that can be started and is hard to reverse. I think the problem has been building over time, but only this bad for about 10 months.

Thank you so much for all your help! I wish more Doctors were like you.

Kristina
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Viewing 6 posts - 1 through 6 (of 6 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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kristina76

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