Donald Corenman MD DC | Spine Surgeon Colorado

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NIKKID17
Participant

December 30, 2019 at 6:04 pm

Post count: 4

in reply to: Microdiscectomy L3-L4 #31835

This is what the new surgeon is saying. None of the MRI has been too helpful & being the difference in the EMG he wants to repeat the MRI. Once I have results I will post it. Thank you so very much you have been more helpful on here than the surgeon whom operated on me. God bless you & what you do for people like me.

NIKKID17
Participant

December 30, 2019 at 7:47 am

Post count: 4

in reply to: Microdiscectomy L3-L4 #31831

I have attached the last MRI I had done. However, I am awaiting insurance to approve the new one with the new surgeon. There were so many different findings on the EMG the old & new surgeon done that the new surgeon doesn’t feel comfortable not doing a new one. I guess mainly I am wondering if any of this is normal from such a “minor surgery”

RESULT:

Indication for the Request / Reason for Overread: Previous report is

inadequate.

Specific Issue(s) Discussed: ? epidural hematoma ? arachnoiditis. ?

evidence of ongoing root compression and/or surgically amenable pathology

? lumbosacral plexitis

Counting reference: Lumbosacral junction. For the purposes of this

report, L4-5 is considered the level of the iliac crest.

Postoperative change: There are postoperative findings related to L3-4

microdiscectomy.

Alignment: Alignment is anatomic.

Bone marrow signal/fracture: No evidence of pathologic marrow

infiltration. No evidence of prior fracture.

Conus: The conus is within normal limits of signal intensity and

morphology. The conus medullaris terminates at L1.

Paraspinal soft tissues: There is a 12 mm T2 hyperintense and T1

hypointense peripherally enhancing fluid collection in the deep soft

tissues adjacent to the posterior inferior aspect of the left L3-4 facet

joint, which were present a postoperative fluid collection. There is

mild surrounding edema and enhancement around the collection. Paraspinal

soft tissues are otherwise within normal limits.

Lower thoracic spine: Visualized lower thoracic canal and foramina are

patent.

T12-L1: Canal and foramina are patent.

L1-L2: Canal and foramina are patent.

L2-L3: Canal and foramina are patent

L3-L4: There are postoperative findings on the left related to the prior

discectomy and fluid collection resulting in mild left neural foraminal

narrowing. There is mild clumping of the nerve roots at the posterior

left aspect of the thecal sac at the level of L3-4. Canal and right

foramina are patent

L4-L5: Canal and foramina are patent

L5-S1: There is mild bilateral facet arthropathy and mild diffuse disc

bulge resulting in partial effacement of the bilateral subarticular zones

and mild contact of the right greater than left bilateral S1 descending

nerve roots. Canal and foramina are patent

Sacrum and iliac wings: The visualized sacrum and iliac wings are

within normal limits.

IMPRESSION:

Postoperative findings related to L3-4 microdiscectomy with a small 12 mm

peripheral enhancing fluid collection in the deep soft tissues adjacent

to the posterior inferior aspect of the L3-4 facet joint, likely

postoperative. Associated adjacent mild surrounding enhancement and

edema. Associated mild narrowing of the left neural foramina. Mild

clumping of the nerve roots at the posterior left aspect of the thecal

sac at the level of L3-4, suggestive of arachnoiditis.

Mild degenerative changes at L5-S1 with mild diffuse disc bulge and

contact of the right greater than left bilateral S1 descending nerve

roots.

NIKKID17
Participant

December 28, 2019 at 6:49 pm

Post count: 4

in reply to: Microdiscectomy L3-L4 #31817

Everything you replied is exactly what I am experiencing. The original surgeon has blatantly refused to even communicate with me on ANYTHING. I do believe in some fashion there may be surgical error & this could be potentially why he has refused to give me any advice or answers.
MRI—-
I am pending a new one from the new surgeon.

EMG —
Muscle bulk is reduced in the left leg with mild quadriceps, tibialis anterior and gastrocnemius atrophy. Fasciculations and abnormal movements are absent. There is no pronator drift. Tone is normal. Neck extensors were 5/5 and flexors were 5/5. Upper extremity power, when graded out of 5, revealed:

Lower extremity strength, when reported the same way, showed:

Right
Left

hip flexion
5
4

hip extension
5
4

hip abduction
5
4-

knee flexion
5
4-

knee extension
5
3-

ankle dorsiflexion
5
0

plantar flexion
5
2

foot inversion
5
0

foot eversion
5
0

toe extension
5
0

toe flexion
5
1

MUSCLE STRETCH REFLEXES:
Comparing right to left and utilizing the NINDS scale (0 = absent; 1+ = less than normal, including a trace response or a response brought out only by reinforcement; 2+ = lower half of normal range, +3 upper half of normal range; 4+ = enhanced, more than normal, includes clonus if present) reflexes are:

Biceps brachii
2+/2+

Brachioradialis
2+/2+

Triceps
2+/2+

Long finger flexors
present/present

Quadriceps
3+/2+

Semitendinosus/
Semimembranosus
present/absent

Gastrocnemius/ soleus
2+/2+
slightly lower on the left

Mild spread in synergistic muscle groups. Vendorovich signs are present, bilaterally. Mild crossed adduction in the lower extremities. Plantar responses are mute, bilaterally. Clonus is absent.

SENSORY: Left L5 >> L4/3 sensory loss. Otherwise normal and symmetric perception of pinprick, vibration. Romberg’s sign absent.

COORDINATION/GAIT: Unable to rise from a chair without using arms.
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Viewing 3 posts - 1 through 3 (of 3 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.

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NIKKID17

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