Donald Corenman MD DC | Spine Surgeon Colorado

Forum Replies Created

Viewing 4 posts - 1 through 4 (of 4 total)

Author

Posts
Maria_2017
Participant

April 25, 2017 at 10:55 am

Post count: 5

in reply to: Spondylolisthesis Grade I/II spinal fusion revision surgery #24703

Thank you so much for your quick and always welcome good opinion.

I had a Posterior fusion with Johnson Expedium hardware and also laminectomy at L5. Would you recommend having a Posterior or anterior fusion? I mean one doctor talked about inserting a cage with screws anteriorly.

Also, from imaging the one screws seems close to the left nerve root but not in there… do you reckon there could be some sort of screw nerve root impingement? I read this in one other post somewhere in here.

Would a revision be easier than the actual first one? or that is difficult to say?

Thank you so much,

Maria

Maria_2017
Participant

April 25, 2017 at 8:46 am

Post count: 5

in reply to: Spondylolisthesis Grade I/II spinal fusion revision surgery #24700

Dear Dr Corenman,

thank you so much for your input on my situation. The neurosurgeon I talked about and was interested in re-doing my fusion at L5-S1 is somewhat reluctant and said (as well as my ortho who performed the surgery) that a second surgery might not work. Or it might work… I am just not sure if they are not sure or if they just do not want to take responsability of the outcome.

Meanwhile, as you said is only a ‘posteolateral fusion (between the transverse processes and the ala of the sacrum)’ as you mentioned but also very little fusion according to the 0.6mm CT scan. Meanwhile MRI does mention possible L5 compression, as I have a L5 diffuse bulge disk that is getting into the foraminal canal (but with no certainty of compression).

Now my symptoms include; severe lumbar pain with bilateral spams; bilateral leg pain that changes from one leg to the other… left leg pain including calf pain; right leg pain with exterior knee pain and external shin pain. I am better resting and worse moving.

I am doing PT for core strengthening and swimming pool walking. I am very limited (not working and even daily life) and not sure as what to do.

Is there any way to know if I have a damaged nerve root? Doctor said that stretching even further by inserting a cage might cause damage.

Can my leg symptoms be caused by the muscle spams? spinal instability? or just damaged nerves?

Thank you very much. I am not sure as to what to do or decide.

Maria

Maria_2017
Participant

February 21, 2017 at 2:59 pm

Post count: 5

in reply to: Spondylolisthesis Grade I/II spinal fusion revision surgery #24402

Dear Dr Corenman,

Thank you so very much for your answers and for caring for patients who are not yours!
It took me a while to digest your information. And meanwhile I have seen my doctor (orthopedic surgeon) that is very interested in following me but wants to avoid surgery. He told me my vertebra L5-S1 were almost bone on bone so no cage and as you said only posterior fusion (that is if it has taken). I am also seeing a good neurosurgeon and I know he wanted to re-do my fusion and place a cage in between.

My question is if I have some sort of chronic neuropathy? When resting and when I wake up I am fine then when I stand up and start moving is the real problem. Is lumbar burning pain from inflammation or nerves.

I will be having an MRI soon.

My doctor worries that a second surgery might not be of benefit.

Thank you for your dedication.

Maria

Maria_2017
Participant

February 16, 2017 at 6:57 am

Post count: 5

in reply to: Spondylolisthesis Grade I/II spinal fusion revision surgery #24340

Dear Dr Corenman,

Thank you so much for your quick reply. I would actually would see you if I was not on in Europe.

When I woke up from my only spinal fusion when they get me to stand up and walk, I had a huge pain in all my left leg that I never had before. From the imaging exams no screw is touching the nerve root, but it is close by. This pain got better over time but sometimes comes back. My question is if I have possible nerve damage?

Also some months ago I did a rhyzotomy on the left leg L5-L4-L3 and L5 transforaminal epidural, did find relief from leg pain but not back pain.

Now I am back to having intense pain with activity and sometimes a shooting pain to my ventral left side (this started a few month ago before rhyzotomy).
Also I forgot to mention that sometimes I have cracking sounds from my spine and some are followed by pain. Is this an indication of vertebral movement and instability?

Is it possible to place a cage even if the space is quite narrow, I believe the doctor tried but could not.

Thank you so very much for your help and care. I am trying to find a solution for this debilitating and depressing situation.
Author

Posts

Viewing 4 posts - 1 through 4 (of 4 total)

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.

Submit your review
First Name, Last Initial:
Email:
Review Title:
Rating:	1 2 3 4 5
Review:

Check this box to confirm you are human.
Submit Cancel

Maria_2017

Forum Replies Created