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salve97
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April 9, 2012 at 4:29 am

Post count: 32

in reply to: Recent Diagnosed Bilateral Pars Fracture with Pain #5985

As posted I will discuss the discogram with the pain clinic and also maybe doing another diagnostic injection on l4 l5 level . I have 18 months to return to work as per my contract . I’ve been out since 12/15 so timeliness essential for a correct diagnosis and surgury if needed. I just hate the waiting between office visits! I have a MRI from 2008 that I sent you in which the pars was not noted. Should I mention that to the Drs or is that of no value to a diagnoses of my pain? in your opinion will work comp stop my quest for the reason for my pain. I assume they won’t as for they want me back as much as I do?

salve97
Member

April 9, 2012 at 12:09 am

Post count: 32

in reply to: Recent Diagnosed Bilateral Pars Fracture with Pain #5983

First of all Happy Easter, and thank you for all your insight with this issue . As I’m sitting here in bed because I could not make it to Easter Mass because of the pain I’m in. I think I’d have this pain no matter what profession I’m in. It’s constant and every day activities seem to maker it worse. I would hope that I wouldnt be ruled out regardless of my profession if i get to that point. My next appointment to the pain doc is April 24th. I am going to suggest the discogram. I think my pain is not coming from the Pars since the injection into the pannus did absolutely nothing . And my pain is about two levels down and almost past my belt line. What are the odds that the pars is a symptomatic and just a coincidence. The MRI says there are central buldges on the L5 level and the emg says there is a pinch on that level . I feel that the calf pain and all other symtoms ( pins and needles) must be related. Could it be we are chasing an injury and pain thatcjust isnt there. Just say if it is a bulge pressing on my spinal cord could that cause the bilateral pain and others symptoms. Also if it is a bulge what options do I have then?

salve97
Member

April 7, 2012 at 10:06 am

Post count: 32

in reply to: Recent Diagnosed Bilateral Pars Fracture with Pain #5973

Hello Dr. Corenman, Thank you for your time today. Giving all the info and the conversation we had to recoop my protocol should be as follows:

Continue conservative treatment (PT and Maybe another injections)
When I feel that I’m go to go back to work have my PT person put a heavy load in my session to see if I can take it. If so then just take it day by day until I have another episode and then:
Go get a Discogram:
Then send it to you …. for review?

You said you think that the L5 looks fine? Its just the L3 /L4 disc?? Should my next injection be in that area?

As for my Calfs and feet having the pins and needles what do you think can be causing that and could that just be aa temporary thing. I thought about the alchohal neorpathy but my liver functions are fine and I just got my yearly physical and did some blood test and those were fine. I’m a social drinker but drank alot in my past so Im stumped with that. This has to be related or just a big coincidence they are seperate. Per our conversation what are your thoughts?

salve97
Member

April 5, 2012 at 1:38 pm

Post count: 32

in reply to: Recent Diagnosed Bilateral Pars Fracture with Pain #5963

Now that I know whT the l3 pain feels like , the pain seems Lower. When they injected it they used a dye and the pars was completely filled in from it? it fell right into the cracks??? Mean anything? As I suspected the left side was much more defined by the dye than the right. But as I said the pain seems now compared to l3 around Si or l5. Funny to is that yesterday my pain was the lowest in months I’d say just below a one. But I did still had some calf pain to be noted. Maybe some nerve damage from different injury or circumstance. Neuropathy. So i did allot of yard work to bring on the pain so i could feel if shot worked. Maybe im just sore from latic acid. But as you mentioned the emg just show a little pinch bilaterally. I sent all docs and test to you already.

salve97
Member

April 5, 2012 at 6:06 am

Post count: 32

in reply to: Recent Diagnosed Bilateral Pars Fracture with Pain #5958

Well I just received the diagnostic injection. At the l3 pars level I had no relief AT All!! It seems my pain is actually lower than the injection sites. I’m completely at a loss now. May e the pain is not from the para defect. And it’s from the DDD on the lower levels. Now what!

salve97
Member

April 2, 2012 at 9:13 am

Post count: 32

in reply to: Recent Diagnosed Bilateral Pars Fracture with Pain #5943

You are right about the OCD because if I didn’t have it I’d still would be chasing a disc bulge instead of a pars defect . No pains at night any different than normal day to day calf pain. I’m just looking for other causes for this calf pain . I’m no drunk but I’m a typical guy who has a six pack watching football games etc. but early in life I would do a lot. Probably just my frustration and sort of depression because it’s been a long time since I’ve been pain free. My calf pain started in left calf on and off . Then the right started recently and now I’m getting the occasional throb in my left , hamstring. this I’m contributing to nerves and stress if this whole situation. But the leg pain is even worse than the back pain recently. Let’s keep our fingers crossed for the injection test Wednesday .
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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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salve97

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