Donald Corenman MD DC | Spine Surgeon Colorado

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Steph810
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November 7, 2018 at 5:33 pm

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in reply to: Cervical Radiculopathy #29777

I have several MRI reports. I believe I had sent you one of them a while back.

Penn Medical Hospital did an MRI in 2014.These is the summary of the findings: MRI findings “C4-C5: Small disc bulge with superimposed trace central protrusion type disc herniation and mild facet arthrosis. No central canal or foraminal narrowing. C5-C6: Small disc bulge. No herniation. No central canal or foraminal narrowing. C6-C7: trace central protrusion type disc herniation without central canal or foramina narrowing” indicate typical findings of degenerative disc and facet disease.

Kaiser Cervical MRI from 10/2018: (History: Bilateral UE numbness chronic neck pain, Last MRI 9/11/2014 in Philadelphia: C2-3 Mild facet arthritis bilaterally c4-5 Small disc bulge with superimposed trace central protrusion type disc herniation and mild facet arthrosis. C5-6 Small disc bulge; C6-7Trace central protrusion type disc herniation Neck Pain, Chronic since 1996)

Finding for MRI/C Spine WO/Contrast dated 7/27/2017:
Procedure: noncontrast enhanced, multiplayer, multi sequence images were obtained through the cervical spine.
CONTRAST: No IV contrast administered
Comparison: NONE
Findings:
Normal cord signal. No ligamentous pathology. No aggressive marrow process. No chiari malformation.
Axiial interrogation reveals
C2-3: Mild facet naturopathy without central canal or foramina stenosis
C3-4: Minimal uncovertebral hypertrophy without central canal foramina stenosis.
C4-5: Mild facet hypertrophy without central canal or foramina stenosis.
C5-6: Small left paracentral disk protrusion slightly effacing the left side of the spinal cord with mild uncovertebral hypertrophy resulting in minimal foramina stenosis.
C6-7: Minimal uncovertebral hypertrophy identified without central canal or foramina stenosis.
C7-T1: No central canal or foramina stenosis
IMPRESSION:
No features of nerve root impingement. No central canal or foramina stenosis
Minimal degenerative changes of the cervical spine with a small left paracentral disk protrusion at C5-6.

Now this last one I had on 10/28/2018 (The Nerosurgeon did a full back because I was having horrible pain in the middle of my back and at the tail bone when I would sit.
These are the reports:

MRI Cervical Spine:
Impression:
1. No acute findings are seen.
2. Interval slight progression of degenerative changes at C5-6 noted as before. No clear evidence of nerve impingement is seen.
NARRATIVE:
Exam MRI?C-Spine WO/Contrast
History: Persistent left neck pain and headache CERVICAL RADICULOPATHY
TECHNIQUE: Multiplayer, multi sequence MRI of the cervical spine was performed.
COMPARISON: MRI cervical spine dated July 27, 2017
FINDINGS:
VERTEBRAE AND CORD: Alignment of the cervical spine is within normal limits. Bone marrow signal intensity of the vertebral bodies is within normal limits. Overall mild degenerative disk disease changes appear somewhat more pronounced at C5-6 in sagittal images and overall appear slightly progressed from the prior exam.

The craniocervical junction is in normal position. The visualized spinal cord shows normal signal intensity.

SOFT TISSUES: no acute surrounding soft tissue abnormality is seen.

C1-2: Mild degenerative changes again seen without significant spinal canal narrowing.
C2-3: The posterior disk margin is normal. The spinal canal and neural foramina are widely patent. Mild to moderate degenerative changes of the facets bilaterally again seen.
C3-4: There is an overall minimal disk osteophyte complex with high greater then left uncinate hypertrophy and mild degenerative changes of the facets bilaterally again see. There is no significant spinal canal narrowing. There is mild narrowing of the right neural foramen without evidence of nerve impingement.
C4-5: There is mild disk osteophyte complex and bilateral uncinate hypertrophy with mild to moderate degenerative changes of the facets bilaterally again seen without significant spinal canal or neural foramina narrowing.
C5-6: There is a disk osteophyte complex somewhat asymmetric to the left with left greater then right uncinate hypertrophy and overall moderate degenerative changes of the facets somewhat asymmetric to the left. Findings bay be slightly progressed. there is mild spinal canal narrowing with a maximum AP dimension central canal measuring roughly 9mm per there is no cord compression. There is mild narrowing of the neural foramina asymmetric to the left without definable nerve impingement.
C6-7: There is a minimal disk osteophyte complex with moderate degenerative changes of the facets bilaterally similar to the prior exam without significant spinal canal or neural foramina narrowing.
C7-T1: There is mild right greater then left uncinate hypertrophy with mild to moderate degenerative changes of the facets bilaterally again seen without significant spinal canal narrowing. There is mild narrowing of the right neural foramen again noted without evidence of nerve impingement.

MRI: LUMBAR SPINE
Impression:
No spinal canal stenosis at any level.
L4-5: Small broad based right posterolateral and foramina disk protrusion abutting the traversing right L5 nerve roots. Mild right neural foramina narrowing.
NARRATIVE:
EXAM: MRI/L SPINE WO/CONTRAST
EXAM DATE AND TIME: 10/18/2018 17:18:00
PROCEDURE: Noncontrast enhance, mutliplanar, multi sequence images were obtained through the lumbar spine.
CONTRAST: No IV contrast was administered.
COMPARISION: None available
FINDINGS:
the conus medullar is and caudal equine are normal.
Normal alignment. The vertebral body heights are preserved with no acute fracture and normal marrow signal. Multilevel mild disk desiccation is seen. The paraspinal soft tissues are unremarkable.
Level by Level analysis:
T12-7: No disc herniation or stenosis.
L1-2: No disc herniation or stenosis.
L2-3: No disc herniation or stenosis.
L3-4: No disc herniation or stenosis.
L4-5: Small broad based right posterolateral and foramina disk protrusion abutting the traversing right L5 nerve roots. Minimal facet disease. No spinal canal stenosis. Mild right neural foramina narrowing.
L5-S1: Very small left paracentral disk protrusion with an annular fissure. No associated neural compression. Minimal facet disease. No stenosis.

MRI THORACIC SPINE:
Impression:
1. No acute findings are seen.
2. Mild degenerative changes of the thoracic spine as noted above. There is no evidence for nerve impingement.
NARRATIVE:
EXAM: MRI/T-SHINE WO/CONTRAST
EXAM DATE AND TIME: 10/18/2018 16:44:00
HISTORY: Thoracic pain, history of child abuse Low back pain
TECHNIQUE: Multiplayer, multi sequence MRI of the thoracic spine was performed.

FINDINGS:

VERTEBRAE AND CORD:
Alignment of the thoracic spine is normal. There are minimal endplate changes associated with degenerative disk disease seen throughout. Bone marrow signal intensity of the vertebral bodies otherwise appears unremarkable. There are minimal degenerative disk disease changes seen throughout on sagittal images. There is a small developmental Schmorl”s node deformity versus chronic central endplate deformity involving the superior endplate of T7 noted.
Visualized spinal cord shows normal signal intensity.
Degenerative changes in cervical spine are better profiled on the separate cervical spine exam.
DISK SPACES:
Posterior disk margins overall appear unremarkable throughout the thoracic spine. There is no significant spinal canal or neural foramina narrowing seen to suggest nerve impingement.
There are mild degenerative changes of the facets scattered throughout.
SOFT TISSUES: The visualized paravertebral soft tissues are unremarkable.

MRI SACRUM

STUDY RESULT
IMPRESSION: Asymmetric hypertrophy of the left piriformis muscle with accessory fibers overlying the left S2 nerve and attaching medially. Please correlate with signs and symptoms of left-sided piriformis syndrome.

NARRATIVE:
EXAM: MRI/SACRUM, WO/CONTRAST
EXAM DATE AND TIME: 10/18/2018 17:35:00

HISTORY: Tailbone pain – please include COCCYX – History of pilonidal cyst Spine Fracture
PROCEDURE: Non contrast enhanced, multiplayer, multi sequence images were obtained through the sacroiliac joints/sacrum.

CONTRAST: No IV contrast was administered.
COMPARISON: None Available

FINDINGS:
No acute osseous abnormality. No suspicious osseous lesion.
No cartilage erosions, osteitis or effusion in the sacroiliac joints.
The lower lumbar spine will be dictated separately. There is asymmetric hypertrophy of the left piriformis muscle with accessory fibers overlying the left S2 nerve and attaching medially.
No abnormality identified along the course of lumbosacral plexus bilaterally. Limited evaluation of the posterior pelvis reveals a small amount of pelvic free fluid, most likely physiologic. Metallic artifact is noted in the posterior subcutaneous soft tissues just distal to the coccyx, most likely related to prior surgery to remove a pilonidal cyst.
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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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Steph810

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