Donald Corenman MD DC | Spine Surgeon Colorado

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westie California
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November 2, 2021 at 6:20 pm

Post count: 138

in reply to: Grafton bone protein – Cervical Laminectomy #34578

Thank you so much Dr. Corenman!

I would like to wish you and family a wonderful Happy Thanksgiving!!

westie California
Participant

November 1, 2021 at 7:39 am

Post count: 138

in reply to: Grafton bone protein – Cervical Laminectomy #34567

Good morning Dr. Corenman,

I’m still dealing with bizarre issues and its become to the point where I don’t know what to do next. I’ve had Botox injections in traps a month ago and some of spams improved and within 2 weeks its back to pre injection status(Botox should give 6 months?). Also during the past 2 weeks I’ve been utilizing a NMES, IFC and Tens combination unit for a minimum of 4 hours a day and still my back of neck is hard like a rock. I’m also in my 9th week of physical therapy and no improvement. The therapist’s all tell me my traps and scalene muscles are all extremely tight.

All I’m told is there’s some residual foraminal stenosis, even after decompressive ACDF’s, laminectomies, facetectomies, foraminotomies and I was fused in a kyphosis at C7/T1. Can C7/T1 kyphosis cause severe spams in traps? thanks

westie California
Participant

October 22, 2021 at 3:17 pm

Post count: 138

in reply to: Grafton bone protein – Cervical Laminectomy #34543

Good afternoon Dr. Corenman,

I hope all is well and do have some additional updates. Per consult today with a D.O. (orthopedic spine surgeon) he went over he’s findings with me:

1) The recent CT Scan was performed using an upgraded apparatus (64 slice verse 16 slice). The 64 slice scanner provides “more detailed imaging”.

2) In 2017 developed kyphosis and pseudarthrosis at C7-T1. A peek cage was utilized at this segment which is “below” previous C3-C7 ACDF’s and laminectomies with instrumentation / fusion. A posterior fusion performed to address pseudarthrosis, however fused in a kyphotic position. The doctor tried to address kyphosis with a partial corpectomy in 2018, however it did very little to address kyphosis.

3)A 2019 Ct scan shows epidural fibrosis “scar tissue” from C3-T1. Can these contribute to nerve pain? It’s possible.

4)The upgraded CT scanner 2020 shows residual foraminal stenosis at C3-C4 left side, which can cause you radiculopathy complaint, however no one in his/her right mind will go in and decompress, since it’s probably permanent in nature, and there’s no way to tell, unless decompression takes place.

5)The base of neck pain is coming from a malalignment of C7-T1. This would probably require an osteotomy down to T4 and would be a significant undertaking with high risk of complications. In his opinion he would avoid any surgery at all cost! He’s advice is work with pain management, physical therapy, try to loss weight, stress management, etc. He agreed that placing a spinal cord stimulator in cervical region is not a good idea, however placement in thoracic area could provide significant relief. He mentioned spinal cord stimulator’s has broader coverage than peripheral nerve stimulator. Any thoughts on this?

westie California
Participant

October 16, 2021 at 10:32 pm

Post count: 138

in reply to: Grafton bone protein – Cervical Laminectomy #34535

Thank you so much Doctor!

It appears from what I’ve read that thoracic outlet syndrome can cause muscle spasms between base of neck and shoulders?

T”he most common symptoms of TOS are:

Numbness and tingling of the fingers or in the arm
Pain in the shoulders, neck, and arms
Impaired circulation to the affected areas
Muscle spasms in the scapular area or upper back – the area between the base of the neck and the shoulders
Chest pain, frequently mimicking a heart condition, that does not go away with rest, and is often relieved with the elevation of the arm
Headaches
Wasting in the fleshy base of your thumb (Gilliatt-Sumner hand)
Weakness of the arm and hand with weakening of hand grip on the affected side
Symptoms become worse with repetitive or overhead activities”.

So if this is the case, and we’re saying less stress is on the muscles because of fusion, and if nerves are not injured or compressed, does this give high probability to TOS as the source of muscle spasms?

westie California
Participant

October 13, 2021 at 7:20 pm

Post count: 138

in reply to: Grafton bone protein – Cervical Laminectomy #34525

Thank you so much Dr. Corenaman!

One last question please, I really appreciate all your feedback and can’t thank you enough! In the past we’ve spoken about disc herniations, kyphosis, stenosis, etc. as a source of neck pain, however I don’t recall much about paraspinal muscle atrophy as being a possible source of pain after cervical laminectomy surgery. I’ve seen some literature that suggests that one can develop neck pain after cervical laminectomy due to muscle trauma. My questions are can this condition cause muscle spams, pain, burning sensation, etc. due to the fact that those muscles can weakened during surgery. From what I’ve read it appear these muscles provide stability to cervical spine and any weakness will cause pain.

I bring these questions up because I’ve had dehiscence and rotational flaps work performed, so I don’t know if paraspinal muscle atrophy can be contributing to my dilemma? If so, are there any treatments? Can Peripheral Nerve Stimulation be indicated for this condition? Thanks

westie California
Participant

October 12, 2021 at 8:10 pm

Post count: 138

in reply to: Grafton bone protein – Cervical Laminectomy #34522

Hello Dr. Corenman,

I spoke to my neurosurgeon and he mentioned what can be done is to add instrumentation from C5, so that there will be instrumentation from C5 to T3. He would add bone graft to help make things more solid. What he explained is, after laminectomies (C3-C7), medial facetectomies (C5-C7) and foraminotomies (C5-C7), it can weaken spine and cause instability. The ACDF’s (C3-C7) and partial Corpectomy (C7-T1) are solid and nothing needs to done from an anterior spine perspective.

What’s your thoughts on this, I want to make sure I ask around before committing? Are all instability issues usually seen on scan’s i.e. flexion\ extension or are some based on clinician’s judgement? Thanks again
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Viewing 6 posts - 1 through 6 (of 122 total)

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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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westie California

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