Donald Corenman MD DC | Spine Surgeon Colorado

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RAESUNRAES
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July 12, 2016 at 9:34 am

Post count: 3

in reply to: CT and Extention Findings #22582

Thank you very much Dr. Corenman for your advice and feedback. Duly noted and I will not go the non hardware route. I did have a second cortisone injection last Tues. as the first one (4 weeks prior) did nothing. This one has alleviated some of the sciatic pain but still have tingling from calf to bottom foot and lumbar pain on both right and left side now. Conservative treatments have been chiropractic therapy, medrol pack, 2 cortisone injections. No physical therapy was ever ordered. Would physical therapy improve my situation?

I spoke to the scheduler while I was there and asked what the exact procedure was that he was planning. His diagnosis and surgical orders are as follows;

Diagnosis
Displacement of Lumbar Intervertebral Disc without Myelopathy

Procedure
Have ISTOS and bone allograft chips graft ready.
L5-S1 right sided hemilaminectomy with facectomy: Distectomy at L5-S1: Non-instrumented fusion of L5-S1: Iliac crest bone marrow aspiration

Apparently I did misunderstand about the slippage but he was in between surgeries when he went over my CT films with me and was rather quick to explain. Possibly he said the slippage wasn’t as bad as what he was seeing on the MRI…

I have scheduled an appointment with a Neuro here where I am located to go over my films and give his suggestions as well. I wish I lived there so I could come to you! My employer is getting close to putting me on short term disability due to my work duty restrictions.

I’m very confused, scared, and extremely stressed about all this. I just can’t imagine living in this pain for the rest of my life. Any other advice you can give would be greatly appreciated!!

Thank you!!

RAESUNRAES
Participant

July 1, 2016 at 1:52 pm

Post count: 3

in reply to: CT and Extention Findings #22518

RAESUNRAES wrote:

Hello Dr. Corenman,

First off I want to thank you for your time and help in what you do for people.

I was hoping you could help me better understand my CT Findings.

Past and current history of symptoms;

Lower back pain off and on for approximately 20 years. This latest onset of pain started 11 months ago consisting of moderate to severe lumbar pain and radiating painful right sciata pain from R lumbar to ankle daily. The pain has progressively worsened over time and now experiencing numbness and tingling from right calf to foot when sitting,driving, coughing. Difficulty putting weight on right foot after sitting for short periods. Recently started feeling more pain in Left lumbar with periodic sharp shooting pain in lumbar and right front center of pelvis.

Treatment
Chiropractor x 3 visits 3 months ago
1 medrol pack (1 day relief mid dose)
1 cortisone injection which did nothing for pain

CT and Xray findings as follows:

EXAMINATION: CT SCAN OFLUMBAR SPINE WITHOUT CONTRAST Clinical history: Low back pain with right sided sciatica

FINDINGS:
Lumbar lordosis appears exaggerated. Intervertebral disc height is reduced at L5-SI with vacuum phenomena, endplate sclerosis anteriorly end plate bony spurs. All the lumbar vertebral bodies

LI L2: No significant neuroforarninal narrowing or spinal canal stenosis.

L2 L3: Diffuse disc bulge noted indenting thecal sac. No significant neuroforaminal narrowing.

L3 -L4: Diffuse disc bulgc noted with superimposed left foraminal disc hemialion sagital image 33/54 causing some narrowing of left neural foramen.

L4-L5: Asymmetrical disc bulge noted with left foraminal disc herniation causing some narrowing of left neural foramen inferiorly sagittal image 33/54

L5 SI: Grade l anterior listhesis of L5 over S1 by 3.6 mm with sclerosis at pars interarticularis (on the left) showing cortical step off without definite discontinuity Right far lateral/foraminal disc protrusion herniation with bony spur sagittal image 19/54 corresponding to axial image 5/17 severely effacing right lateral recess impinging on right traversing nerve root and causing moderate narrowing of right neural foramen.

Pre-and paravertebral soft tissues including the visualized abdominal aorta and bilateral kidneys appear unremarkable.

XRAY OF LUMBAR SPINE WITH FLEXION AND EXTENSION

FINDINGS:
Lumbar lordosis exaggerated
Intervertebral disc space is reduced at L5-S1 with endplate bony spurs.

Grade 1 anterior listhesis of L5 over S1 noted.

Facet joint hypertrophic changes are noted at L4/L5.

On flexion and extension views no changes noted in the severity of anterior listhesis of L5 over S1. At rest of the lumbar levels no instability noted.

Visualized soft tissue shadows appear unremarkable.

IMPRESSION:

l. Grade 1 anterior listhesis of L5 over S1 with reduced intervertebral disc space

My surgeon quickly looked at the film’s only as he had not received the report and said no slippage or pars fractures. He said surgery is needed with 2 options dependent on how much time I could afford to be out of work.

A. Full cage? This would alleviate both lumbar pain as well as sciatic pain and compression. 3 months out of work.

B. Microdistectomy with partial fusion on left side utilizing salvageable bone from my right side and possibly cadaver bone and doing a non hardware fusion to my left side for better stability.

I’m a 48 years old female and very scared that I may not be able to perform my job in the medical field as it requires some manual labor and driving. Do you agree with the recommended treatments my surgeon has given?

I failed to include that he said option B microdistectomy would only put me out of work for 3 weeks and that it would relieve the sciatica pain but may not relieve all my lumbar pain.

Thank you very much for your time and input!
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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.

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RAESUNRAES

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