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October 29, 2016 at 7:57 am

Post count: 12

in reply to: Sharp stabbing pain post discectomy #23302

Thanks once again for your altruistic service to those of in back pain. Yesterday, I actually had a pretty good day, virtually no pain in my butt and lessening in my lower leg. Pretty good bit of pain in both butt and leg this morning for a while after getting out of bed but better now after two Alleves and heat pad. The day before that, I was 95% convinced I had re-herniated. Your response as above keeps me optimistic. I don’t see my NS until 12/5 but I am fairly sure I can call my neurologist and get him to order the MRI with Gadolinium as you recommended. If re-herniated, there should be no problem in getting into see the NS for earlier consult.

At time of surgery, he had indicated that he was not a fan of PT as he had had pts. that had gotten into trouble by doing it. Walking was about all he recommended. He’s a good patient guy but you have to really pull info out of him which is why I do so much research on my own. I don’t have doubt that his surgery was as good as anyone could have done so that’s good. I do wish to goodness that he had mentioned that doing the “nerve flossing” would keep the scar tissue at bay as I would have been doing it religiously.

So…couple of additional questions. If the MRI shows scar tissue, is there anything that can done about it and will flossing at this point help? What can be done if there is seroma or hematoma or do those conditions just simply reabsorb on their own.

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October 27, 2016 at 3:51 pm

Post count: 12

in reply to: Sharp stabbing pain post discectomy #23286

Thank you Dr Corenman for you kind response. Whereas when I had follow up with my NS on 11/24 and I was having some pain in my lower back and brief messages to my ankle area, today, my pain is worse today, a 5 to 6 which is constant, whether sitting or standing. The locus of pain is perhaps half inch to right of the incision and half inch down from that which is running into my right buttock. Now having constant sciatica, chiefly the right side of my calf and towards the back of my right ankle. No sciatica in the thigh or feet. No muscle weakness, no tingling. I did the hamstring stretch you referenced. Both legs were quite naturally tight as all I have been doing is walking and no stretching out of fear of triggering that nerve root which is quite an eye opener when I do. So…tightness but the stretch did not cause any pain on either side

As I mentioned in my OP, the pains from the original herniation came on quite suddenly. My current state has been a slow progression up to this point from 6 weeks post op and I am now 9 1/2 weeks out which is really odd to me but I suppose herniations can come out gradually just as well as suddenly.

If this is chiefly due to scarring and not herniation, is there anything that can be done? Would an epidural shot possible be of any help (I’ve already had 3 pre surgery)? If re-herniated, would there be any merit in getting another epidural before considering another discectomy? Finally, I have read your responses elsewhere here where you have indicated that MRIs can be done fairly soon after surgery. My N/S had said at my meeting with him on 11/24 that it is too soon and would not show anything conclusive. Any specific method of MRI I could mention to him that would be the best…with or without galadnium? I really want to rule in or rule out the re-herniation quickly especially since my insurance calendar year starts again in January. Thanks again. Best
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Donald Corenman, MD, DC

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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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