Donald Corenman MD DC | Spine Surgeon Colorado

Forum Replies Created

Viewing 6 posts - 1 through 6 (of 11 total)

1 2 Next

Author

Posts
ol99
Participant

March 23, 2021 at 6:53 am

Post count: 14

in reply to: Indications for surgery #33795

Ok, I’ve send an email to my doctor to try to diagnose the foraminal collapse. This might be the closest I’ve been to get a proper diagnosis for my condition.

I did look at the MRI, and there seems to be asymmetry/collapse going on in the right side of the L5S1 segment. Very subtle and easy to miss unless I”mw rong. There’s also some kind of hollowness in the sacrum, not sure if that’s bad…

These are xrays:

i.imgur.com/ZgydQU7.png

i.imgur.com/OLJZARL.png

ol99
Participant

March 22, 2021 at 12:46 pm

Post count: 14

in reply to: Indications for surgery #33786

And I guess a bone spur would be seen on MRI?

ol99
Participant

March 22, 2021 at 12:23 pm

Post count: 14

in reply to: Indications for surgery #33785

Shouldn’t be missing anything. I was just wondering what would explain why I more L5 compression on the right nerve and not so much on left. Perhaps that’s relatively common with instability?

ol99
Participant

March 22, 2021 at 9:13 am

Post count: 14

in reply to: Indications for surgery #33783

OK, got it!

Before a fusion though, would there be value in getting a CT?

I’ve only had an MRI, and due to the weird nature of my injury, I was wondering whether a CT for spondylolisthesis would have an effect on the surgeon’s strategy for the surgery.

I injured myself doing an extension with rotation movement, which may have broken the pannus on the right pars. I’m guessing that’s why I only have compression on the right L5 nerve – I have almost no symptoms on the left L5. There is potentially some kind of rotation movement going alongside the sliding of the vertebrae.

ol99
Participant

March 22, 2021 at 1:43 am

Post count: 14

in reply to: Indications for surgery #33780

Thanks Dr. Corenman for explaining this stuff, it gives me a better picture of what to expect in the future. I will definitely post an update here in case I get a fusion.

One doctor mentioned injections – I once had a bilateral S1 interlaminar nerve block, which didn’t help with the leg pain from where my L5 is getting crushed. Does the injection need to be done differently for my condition? Like, would the L5 nerve need to be targeted in a transformational approach at L5S1, or directly in the root at L4L5?

Also, have a question about OLIF – I know you prefer TLIF, and I can go with that, but what does indirect decompression mean? Does that mean that a part of my protrusion might stay after the fusion? Or is the disc space completely cleared? I don’t have any extrusions or sequestration from the disc, apart from the annular tear. Other than that, I guess OLIF (with posterior fixation) might be too experimental still to try on an unstable segment?

Asking because I have one offer for a TLIF and another for an OLIF. I’d trust your judgment on this – would even come to your clinic but I’m too far away.

ol99
Participant

March 21, 2021 at 3:24 pm

Post count: 14

in reply to: Indications for surgery #33775

Interesting that you note the pain from switching between retrolisthesis and anterolisthesis. I’ve felt that type of pain but never knew that this was the reason why. I’ve had that kind of switching pain (when going from standing to lying down) ever since I was in high school, I guess that’s when I developed the pars defects.

I’m not really against surgery, some days I do think about scheduling it. I’m just scared of the unknowns.

What are the chances I get worse with surgery? Like for example, my gait issue doesn’t get resolved and I start having more pain?

Are there people that don’t have to get a second or third fusion? I’m 32, so worried I’ll get fused up to L2 or L3 by the time I’m 70.

And finally, is surgery easier and more successful if I stop my isthmic spondylolisthesis while it’s grade I? Can this progress to grade II or III? The doctors noted the slip has progressed over time.
Author

Posts

Viewing 6 posts - 1 through 6 (of 11 total)

1 2 Next

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

ol99

Forum Replies Created