Donald Corenman MD DC | Spine Surgeon Colorado

Forum Replies Created

Viewing 2 posts - 1 through 2 (of 2 total)

Author

Posts
mdrizzo1
Member

October 3, 2012 at 9:28 pm

Post count: 3

in reply to: Thoracic / Shoulder Blade pain after ACDF – 6 months post op #7100

Thank you, I am pursuing the CT scan. My surgeon constantly reiterates “your neck is fused, it’s not your neck”, frustrating.

One additional question…if the pain was facet originated, wouldn’t the facets directly below the fusion site (in my case C4-C6 ACDF) bear the brunt of the new load? (around C6-C7?) My pain management doctor did two rounds of facet injections at T3-T6 which provided no relief. Then a cervical epidural (no relief). That is roughly where my pain/stiffness is located (between shoulder blades/thoracic), but I’m wondering if the pain is stemming from directly below the fusion site and if that “maps” to my shoulder blades/rhomboid area. Thank you.

mdrizzo1
Member

July 27, 2012 at 8:54 pm

Post count: 3

in reply to: Thoracic / Shoulder Blade pain after ACDF – 6 months post op #6599

Dr. Corenman,

After several rounds of facet joints injections, constant NSAIDS and muscle relaxers, my symptoms in my original post have persisted. (thoracic/paraspinal and trapezius pain/spasms – upper/mid/lower trapezius and paraspinals. No lumbar pain). I am now 10 months out from the ACDF.

I was sent back for a C and T MRI. The results are as follows:

C spine:

Findings: Lower posterior fossa is normal. Craniocervical junction is intact. There is straightened cervical spine lordosis with preserved alignment, normal marrow signal, and no prevertebral soft tissue swelling. There has been interval anterior cervical discectomy and fusion C4-C6 and C5-C6 with apparent osseous integration of the intervening bone graft material.

C2-C3: No abnormality.
C3-C4: Minimal right uncovertebral hypertrophy. No disc protrusion or mass effect.
C4-C5: Canal is decompressed status post fusion and discectomy.
C5-C6: Canal is decompressed status post discectomy and fusion. Recesses and foramina are patent.
C6-C7: Very subtle and minimal less than 1 mm grade retrolisthesis C6 on C7 without disc protrusion or mass effect
C7-T1: No abnormality

The cervical spinal cord demonstrates normal caliber and signal without syrinx. There is no abnormal enhancement or mass.

Impression:
1. Status post ACDF C4-C6 with decompressed canal, recesses, and foramina.
2. No new disc protrusion or mass effect upon the canal.
3. Cervical spinal cord demonstrates normal caliber and signal with syrinx or abnormal enhancement.

T spine:

Findings: The thoracic vertebral bodies are aligned with normal marrow signal. There is very mild exaggeration of thoracic kyphosis. Paraspinal tissues are intact.

There is nonacute endplate Schmorl’s node T7-T8 with small central disc protrusion without mass effect. Disc dessication with loss of height T8-T9 with mild posterior endplate degeneration and small central disc protrusion without mass effect. Small central disc bulge T10-T11 without mass effect.

Cord terminates at T12. The thoracic spinal cord demonstrates normal signal and caliber w/o syrinx.

Impression:
1. Small disc protrusions mid and lower thoracic spine w/o mass effect.
2. Thoracic spinal cord is normal

As a healthy (except for this) 28 year old, it seems concerning my spine is falling apart. To the layman (me), it seems like my neck fusion was successful, and now my thoracic has some issues. The Schmorl’s node mentioned at T7-T8 is I believe right about where my pain is worst(lower between my shoulder blades). The T8-T9 dessication I knew about from a MRI 2 years ago, although that was the only issue and was causing me no pain at the time.

Although the MRI mentions no mass effect, if I was your patient what would be your recommended course of action? I would certainly prefer a conservative approach of course. Much thanks.
Author

Posts

Viewing 2 posts - 1 through 2 (of 2 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

mdrizzo1

Forum Replies Created