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thebird
Participant

March 22, 2018 at 5:16 pm

Post count: 23

in reply to: Symptom question #27922

Hi Dr Corenman,

Latest update I have is, my condition has worsened to adhoc leg weakness. There was no explanation found of protein elevation and symptoms worsening. Referred back to Neurosurgeon to consider decompressing the cervical spine as last resort. The Neurosurgeon ordered more MRI to rule out dural fistula. The radiologist has confirmed his suspicion in the T spine. Diagnosis has not been made yet as still under review.

The NS mentions he suspects a secondary issue as all symptoms do not fit fully yet however this is now the priority. He will be assessing it, some more scan and operating on me. He said this is extremely rare, and given my age. It was missed due to no cord swelling on previous MRIs. Only that this last check with contrast located it.

Do you have any knowledge of this?

thebird
Participant

February 26, 2018 at 1:34 am

Post count: 23

in reply to: Symptom question #27706

Thanks Dr Corenman.

Have had further review by immunologist to no answers.

Back at the original neurologist today and after discussions he is now suspicious of electricial issues causing my symptoms and raised protein. Has scheduled me for an EEG and prescribed Epilim to trial after the EEG.

Has also ordered T3 MRI imaging of brain and c-spine again to give up any other clue. He advises T3 imaging can show more around blood vessels that could be bleeding to try help explain raised protein.

The discs bulges are still at the end of the list. The new information I received today makes good sense, hopefully this might be the right track!

thebird
Participant

February 16, 2018 at 1:27 am

Post count: 23

in reply to: Symptom question #27580

That’s ok, I appreciate you following my progression and more than happy to share my experience. I understand that a lot of threads here are unusual, because if we had answers we would not resort to this. Plus, you seem to be the only spine expert offering such a service. I wonder if you can help with a few questions as I am determined not to give up and try get a diagnosis that can hopefully lead to treatment.

Further to the lower legs stinging (not in feet), and what seems like vestibular dysfunction, neurologist labelled it possibly ataxia that I briefly feel off balance or delayed signal of my leg movements when walking. I have started having stinging in my right arm, not in hands but my under arm from elbow to hand, however it is intermittent. The neurologist is still of the opinion my symptoms are very much of spinal pathology. So here is a few questions, if you may answer as best you can I would appreciate it.

1. Can elevated protein in the lower spine build up from CSF disruption by my protruding discs as we have found no cause of inflammation or any trace of MS?

2. Should I start looking for a Neurologist that specialises in unique situations such as mine? My current neurologist is very good but I understand he is more so special interest in MS etc and not as much as spine. However I don’t doubt his knowledge at all.

3. Is there any further imaging or tests that could be done around my symptoms, to see if the cervical level is responsible? Taking in mind I’ve had full spine mri, 2 brain mri, ct of cervical spine. All enhanced with dye etc.

The only findings identified are elevated protein, and 2 disc protrusions flattening the cord with CSF present posteriorly.

thebird
Participant

February 14, 2018 at 8:53 pm

Post count: 23

in reply to: Symptom question #27556

Hi Dr Corenman,

Stuck again it seems.

Have had PET scan and CT scan of chest looking for neurosarcoidosis/sarcoidosis. Results given were all clear. Nothing sinister happening on either scan. The Neurologist has now said we have no explanation for raised protein as unable to find inflammation. He did not like to but has put me on 25mg steroid per day for 5 days then 10mg for 5 days after to see if there is any relief.

If there is none of this relief, then there is the need to reconsider the discs as been responsible for my problem however it does not explain raised protein in CSF and also the fact that imaging does not show evident compression, as CSF is noted behind the cord.

I assume per your prior response, there is no more answers and have pretty much run out of tests now. One option he said is refer me onto an immunologist even though my immune tests were clear to review it all. So I think that is happening.

Very difficult situation.

thebird
Participant

February 2, 2018 at 4:25 am

Post count: 23

in reply to: Symptom question #27440

I will. Thank you for your help through this process.

Kind regards

thebird
Participant

February 1, 2018 at 11:33 pm

Post count: 23

in reply to: Symptom question #27437

Hi Dr Corenman

Am getting somewhere now. CSF fluid has shown elevated protein levels. Neurologist advised this is the cause of my symptoms as the spinal cord is inflammed. He is now trying to find the cause of inflammation and has Scheduled me for multiple scans.

He believes the nerve pain in my legs is not a neuropathy and that’s why I keep passing tests. He suggests this is just sensations from the cord inflammation that is going on.
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Viewing 6 posts - 7 through 12 (of 22 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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thebird

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