Page 11 » Donald Corenman MD DC | Spine Surgeon Colorado

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westie California
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August 5, 2020 at 10:27 am

Post count: 138

in reply to: Posterior foraminotomy of the cervical spine #32811

Dr. Corenman,

Two quick questions please:

I was told by pain management that C3-C4 is definitely contributing to my pain, however surgeon stated that this segment can’t be treated surgically because “bone spur is inside where you were fused”. Can you explain what is meant by this?

My next question is in reference to my T1-T2 pseudarthrosis. Can this non union improve over time with my anterior partial C7-T1 corpectomy -titanium cage or would a revision procedure with hardware be more appropriate? Thanks always Doctor, hope all is well on your end.

westie California
Participant

July 7, 2020 at 6:26 pm

Post count: 138

in reply to: Posterior foraminotomy of the cervical spine #32725

Good evening Dr. Corenman,

I’m sorry for all the questions on proposed C2-C3 posterior fusion surgery. Per my telemedicine consult today, surgeon is stating that C2-C3 requires a fusion due to severe facet degeneration and is contributing to symptoms of base of skull pain, right side occipital headaches, and imbalance. He commented that I have neurological issues with tandem gait i.e. can’t perform heel toe test.

He is reluctant to perform T1-T2 fusion to correct pseudarthrosis since he feels that both issues need to be addressed while he’s in there. I’ve expressed my concerns on additional reduction with my range of motion and he doesn’t seem concerned, stating “some loss can be expected, but you will have at a minimum 50% to 70% improvement in your pain”. From what I can see online most of our range of motion comes from C0-C1, C1-C2, C2-C3. Is this information correct in reference to ROM? I also had a anterior partial corpectomy with titanium cage at C7/T1 back in November, my question is will this help a T1-T2 pseudarthrosis when totally healed? Thanks again

westie California
Participant

June 27, 2020 at 6:12 pm

Post count: 138

in reply to: Posterior foraminotomy of the cervical spine #32711

Dr Corenman your the best! We all appreciate everything you do for us. Thanks so much again

westie California
Participant

June 27, 2020 at 4:11 pm

Post count: 138

in reply to: Posterior foraminotomy of the cervical spine #32708

Per my reading from others on this forum, C2-C3 base of skull pain and headaches, usually are treated and diagnosed with facet blocks and if one gets relief the next step would be RFA? Surgery at this level is usually reserved for instability, fractures, etc. So for me I think it would be wise just to have The T1-T2 posterior fusion due to pseudoarthrosis? Thanks always in advance

westie California
Participant

June 26, 2020 at 7:36 am

Post count: 138

in reply to: Posterior foraminotomy of the cervical spine #32703

Good Morning Dr Corenman,

That is correct, I do have base of skull pain. I’m not aware of any instability, however I’m told that there’s a large bone spur on facet at this level C2-C3. My last MRI states “at the C2/C3 disc space level, disc herniation is noted deforming the thecal sac abutting the spinal cord contributing to mild central spinal stenosis in conjunction with posterior ligamentous hypertrophy. There is no evidence of neural foraminal stenosis. Loss of disc signal is noted with preservation of disc space height”. Why a fusion is warranted at this level is confusing to me and I’m not willing to lose more range of motion.

I have two opinions at this point, first surgeon wants to perform a revision to T3 (hardware from C5 to T3), the second is revision to T2 (hardware T1 and T2) and C2/C3 fusion (hardware C2/C3). Thanks in advance

westie California
Participant

June 25, 2020 at 4:55 pm

Post count: 138

in reply to: Posterior foraminotomy of the cervical spine #32698

Good evening Dr. Corenman,

I had a consultation today with my surgeon and a flexion-extension x-ray was performed and my CT scan was reviewed. The x-ray showed movement at T1 and T2 and CT scan showed non union. So he wants to perform a fusion revision and add rods and screws at this level posteriorly. In addition he would like to fuse C2/C3 with rods and screws. My question is, how would a C2/C3 impact my range of motion? Thanks
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Viewing 6 posts - 61 through 66 (of 122 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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westie California

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