Page 11 » Donald Corenman MD DC | Spine Surgeon Colorado

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Renee123
Participant

April 24, 2016 at 11:16 pm

Post count: 130

in reply to: Pars Injections #22051

Sorry to ask again but if a ALIF is done what is the risk of not removing the pars fracture? Is there anyway to determine from a CAT scan or an MRI if there are bone Spurs ? Also once the segment is stabilized will the pain fibers in the pars fracture create a problem ?

Also how painful is the TLIF the first week? Is pain well-controlled with iv pain meds ?

My issue is that I do not believe most surgeons are as skilled as yourself with TLIF for isthmic spondy!

Renee123
Participant

April 23, 2016 at 10:19 pm

Post count: 130

in reply to: Pars Injections #22041

For a cervical isthmic spondylolisthesis when you do a cervical fusion you approach the neck from the front and use a plate to hold the cage in place, correct ? There is not posterior fusion.

I was just curious why the same procedure is not used at L5,S1 ? Isn’t it the same problem just at a different level ?

Renee123
Participant

April 21, 2016 at 9:28 pm

Post count: 130

in reply to: Pars Injections #22032

Istmic spondylolisthesis must be the pain generator because I can not walk or stand for very long at all, but I have no trouble sitting or laying down. I am in no pain when I am not “loaded” so I am assuming this is not coming from a herniated disc?

As you stated the surgery is the same. Can’t do microdisectomy because that will increase the slip, correct? In addition the disc at L5,S1 is 50% degenerated.

The question is weather to have a ALIF 360 with minimal invasive screws and rods or TLIF. Surgeon seems to think that if I don’t get a lot of relief with pars injection that I might be better off with ALIf 360 with perc screws, but it is up to me.

Does this diagnostic/surgical approach with the pars injection make sense regarding ALIF 360 vs TLIF ?

Renee123
Participant

April 20, 2016 at 11:52 pm

Post count: 130

in reply to: Pars Injections #22027

Also, hypothetically, if pars injections did nothing, but I got relief from an epidural or some other form a diagnostic injection into the disc area, could I have a microdisectomy instead of fusion?

Renee123
Participant

April 19, 2016 at 5:58 pm

Post count: 130

in reply to: Pars Injections #22020

my only issue is L5,S1.

Would facet blocks do anything at all or even worth the time ?

MY surgeon wants me to have a pars block before the TLIF to gage how much pain relief I can expect from surgical intervention.

It doesn’t really seem to make much difference because I can not stand, sit or walk for very long so I would assume that the mechanics need to be fixed. I’m just looking for a last minute miracle before surgery.

Please let me know your thoughts.

Thank you again for all of your help. You are a great Dr. !

Renee123
Participant

April 18, 2016 at 11:22 pm

Post count: 130

in reply to: Pars Injections #22005

I meant to say the Dr. Recommended facet blocks with the hope that the steroid would leak into the pars fracture ??

Very frustrating because pain is well
Controlled as long as I’m not moving around too much !
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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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Renee123

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