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sperryguy
Participant

January 20, 2016 at 7:00 am

Post count: 68

in reply to: Incomplete Spinal Fusion #21181

Hi

Yes, I will be looking into HSS, awesome facility. I had my surgery at Lennox Hill, also quite good. I like/d to work out, though not into weights. Before surgery, despite all the pain, was working out. After surgery, walking quite a bit. My pain doctor indicated that I may benefit from an SI ablation. His thinking is that due to the stiffness of the interbody device, is transferring the stress to the SI Joint. He wants to do a SI block and see if that stops the pain. Despite it all, still doing my best to keep fit.

I found eating nutritiously before and after surgery is tantamount to healthy recovery. Walk, walk, and walk some more. Get plenty of rest, and have someone to help you around your home for the first few weeks. I only used a walker for a few days, and never moved on to a cane. My doctor did give me a spine stimulation device, and that is helpful. I was very careful to eat high fiber foods to avoid constipation, and to avoid nausea post surgery, was put on a anti nausea patch the night before, and kept it on for a week after the surgery(have a sensitive stomach). Will keep all of you up to date. Hopefully my body will continue to fuse, one never knows, though planning for it not happening at this juncture(15 months out)

Steve

sperryguy
Participant

January 19, 2016 at 8:08 am

Post count: 68

in reply to: Incomplete Spinal Fusion #21174

Hi Renee

The surgeon did use BMP on all places. I question if the facets actually fused vs a psuedoarthrosis. The doctors are somewhat baffled on the poor results. The Ortho Surgeon suggested (in the near future) a Bone Scan to determine which spots are “HOT”. I will certainly look at the Rothman Institute, but i doubt they accept my insurance being out of NYC. However, I am researching physicians out of NYU/Hospital for Joints Diseases.
Again, thank you for your help!

Will keep all of you in the loop

All The Best

Steve

sperryguy
Participant

January 11, 2016 at 10:58 am

Post count: 68

in reply to: Incomplete Spinal Fusion #21165

Hi

My doctors did use BMP, though my CAT Scan indicates some fusion in my facet joints, all other places didn’t work. Thanks to all for reading and help. Will keep the forum up to date on my progress.

Regards

Steve

sperryguy
Participant

January 6, 2016 at 10:02 am

Post count: 68

in reply to: Incomplete Spinal Fusion #21153

Hi Dr C

Another followup that I would like to share with the forum. After a consult with the co-surgeon(neurosurgeon),(THE MAIN SURGEON WAS ORTHO) he suspected that my pain was coming from the SI joint. I did point out that the pain was similar, though not as severe prior to my TLIF surgery. He said that this symptom is not uncommon. He recommended an SI block injections, and if successful, undergo an ablation of the SI Joint/S. I pointed out that while that may resolve the pain temporarily, its not a long term solution. The doctor did order a CAT Scan and an XRAY(flexon extension). My doctors did have a consult and explained that based on the latest CAT SCAN , the facets joint are fusing and he hopes that will continue. The two other spots which received the bone graphs have issues, one area(he said less important in the front?) was completely absorbed, thus no fusion. The area between L4/5 hardly fused. The orthopedic surgeon said not to give up hope and it still may fuse(14 months post surgery). He said if the pain continues and quality of life is still affected, he would consider revision surgery. He said it wouldn’t be as severe since all else is in place and there are many “strategies” he can suggest. He also suggested that a bone scan to see where the “hot” spots are, but that wouldn’t be until he is certain I am not getting any better. I transcribed the relevant portion of the CAT Scan :
L4/L5: Posterior fusion has been performed. Complete mature appearing fusion is not visualized. There does appear to be further fusion involving the l4/5 facet joints when compared to the prior exam. Metallic Inter-body device is again noted. Device does not appear entirely incorporated. Endplate concavity is present adjacent to the device with associated sclerotic change. Again findings consistent with subsidence and they appear slightly more prominent than previous exam.

Summarize

The pain has been increasing and any real exercise program(stepper, biking) results in severe debilitation for about a week time. I also noticed that my left leg feels increasingly weak as the moth progresses.

At this juncture I don’t know whom to believe and if the “team” is telling me the whole story. Can you help me sort this out?

Thank you again for all your help!

Steven

sperryguy
Participant

November 27, 2015 at 9:18 am

Post count: 68

in reply to: Incomplete Spinal Fusion #20855

Thank you again Dr Corenman.

Is it possible for you to provide a “long distance” consultation? I have ordered all my imaging studies with the corresponding reports to ascertain what exactly is happening.

Thank you again

Steven

sperryguy
Participant

November 13, 2015 at 10:30 am

Post count: 68

in reply to: Incomplete Spinal Fusion #20738

Hi Dr C

Just an update on my TLIF L4-5 surgery (11/10/14). My lower back pain has continued to increase in what appears in almost the same spots prior to my surgery. I have been to a neurosurgeon and as explained in prior posts, he couldn’t see the fusion, though it was mentioned the devices may be blocking. He mentioned my only option after waiting another year would be revision surgery. I have been going to my PT for core training and returned to my pain doctor for facet block injections. The first set I did quite well. The second set didn’t really work. The physician said he didn’t see any real fusion (a little clouding) and my pain appeared to be coming from L5 and at the surgical site. He suggested I may be able to have an Endoscopic Facet Rhizotomy. My question is does it matter who performs the procedure(thinking a neurosurgeon is preferred)? If have tried to returned to my old physical activity and the aftershocks are painful. I have made an appointment to discuss with the neurosurgeon. I would like to discuss with the surgeon on options? If revision surgery is an option, should i consider it? Do I have options other than continued pain meds(take almost nothing since it makes me ill), continued injections? What type of surgery is an option? At 59 years old i was hoping for better improvment. My orthopedic surgeon just tells me he see some fusion arounf the facet joints, though the other doctors see almost nothing. As always, I greatly appreciate your input.

Steven
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Viewing 6 posts - 43 through 48 (of 65 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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sperryguy

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