Page 17 » Donald Corenman MD DC | Spine Surgeon Colorado

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Renee123
Participant

February 15, 2016 at 8:22 pm

Post count: 130

in reply to: L5, S1 isthmic spondylolisthesis #21359

Thank you very much, that about sums it up !

I am told at L5,S1 there would be a horizontal incision and the vascular surgeon would be going underneath the bowels to the spine, not retracting them. The incision is in the pelvic area would be approximately 6 inches. I agree that there seems to be no point in taking the risk if TLIF can be done. However, as a female, I think many Dr’s believe there is less risk than a male.

Having a 4-6 inch incision down the middle of the back doesn’t sound like much fun either. I guess it depends on how the surgeon was trained.

I am in full agreement with you, I don’t see how tunneling through abdomen can cause absolutely no adverse effects. I was unaware of adhenions that can form around the arteries !

Renee123
Participant

February 14, 2016 at 11:35 am

Post count: 130

in reply to: L5, S1 isthmic spondylolisthesis #21341

Dr. Corenman, you are a great surgeon and you have a great way of communicating with people. This is hard to find with other surgeons. Thank you !

To answer your question, the theory behind having an ALIF with minimal invasive “perc screws” is to avoid a midline incision of 4-8 inches on the back and also to avoid muscle stripping and scar tissue. Many surgeons have suggested leaving the pars fracture in place to avoid muscle and nerve disruption thereby only using the mini-open perc screws. I have no current leg pain or numbness so this surgery was suggested many times as it is suppose to have a faster less painful recovery.

Keep in mind that most spine surgeons are not as skillful as yourself, it is an easier surgery to go through the abdomen and probably more expensive as well. Many surgeons make the argument that placing a cage through the front with BMP will heal faster and give better support with more bone fusion.

However, there are a couple very experienced surgeons that have told me the pars fractures needs to be removed even if I am not having leg pain. As mentioned, one suggested TLIf leaving half of the pars fracture in, which makes no sense.

1.) What are you thoughts on this ? I read about the bone spurs, but again there are no leg symptoms.

2.) Also, what are you thoughts on Sperryguy. How could he have a posterolateral fusion without fusion in the disc space ? Seems impossible.

Thank you again !

Renee123
Participant

February 11, 2016 at 12:05 am

Post count: 130

in reply to: L5, S1 isthmic spondylolisthesis #21317

1.) Can you please explain this last part to me “BMP has a learning curve and if used properly, will not generally overgrow if used in the disc space.” What kind of learning curve ?

It would seem to me that very small dose of BMP should be included in the disc space, where is the danger ? MY surgeon only wants to use BMP on the sides.

2.) Could I wind up with a later fusion and not a fusion in the disc space, like sperry guy ?

3.) Also, what are you thoughts on ALIF with posterior mini open pedicle screws and leaving the pars fracture in. Is this acceptable to you ? It doesn’t matter if I fuse ALIF or TLIF, once you fuse you win, right ?

Getting ready to schedule and wish I lived closer to you.

Renee123
Participant

January 25, 2016 at 4:32 pm

Post count: 130

in reply to: L5, S1 isthmic spondylolisthesis #21198

Hey Dr. Corenman:

Can you answer the above please :

1.) I met with one surgeon who says he does TLIF for the pars fracture, but only does the traditional TLIF and removes half of the pars/facet to access the disc space leaving, I guess, the other side of the pars fracture in tact…does this sound right to you ?

2.) Also, I met one other surgeon regarding TLIF, who says he will remove entire pars fracture, however does not use BMP within the disc space, however he will use BMP along the screws and rods. He says sometimes BMP in the disc space can grow into the spinal cord. He was a a good surgeon and said once I fuse it doesn’t matter which method was used.

Please let me know your thoughts. I am going to schedule soon.

Thank you !

Renee123
Participant

January 19, 2016 at 10:35 pm

Post count: 130

in reply to: Incomplete Spinal Fusion #21180

Did you check Hospital for Special Service? They are #1 in orthopedics in the US !

Did you do any early exercise, lifting or anything like that ? Let us know what the Dr.s say. I am going to schedule my TLIF soon…

Thanks again !

Renee123
Participant

January 18, 2016 at 10:59 pm

Post count: 130

in reply to: Incomplete Spinal Fusion #21173

sperryguy,

FYI, I met with my surgeon today. He uses BMP for the fusion on the sides where the screws and rods are not in the disc space. Perhaps that is why you only fused in the one part. Ask your surgeon exactly where he used the BMP.

Dr, Corneman uses BMP in the disc space as well in front of the cage. MY surgeon says he will only put part of my bone from the laminectomy in the front.

You may want to look up the rothman institute in phili, I hear they have very good surgeons there.

Keep in touch.
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Viewing 6 posts - 97 through 102 (of 113 total)

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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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