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wgreenlee
Participant

May 6, 2017 at 7:27 pm

Post count: 53

in reply to: ACDF Post-operative Concerns with CT-Scan results #24739

I was also going to let you know I have had issue’s swallowing since the surgery in 2015. Every time I eat something it get’s stuck in the throat. The first bite that is. There are two reactions. One it comes back up or I finally get it down after a minute or so and then get hiccups. Not fun. I guess I’m telling you this because I had a modified swallow test and the doctor told me that the muscle that controls the esophagus expanding is hitting the metal plate. Of course when I told her I needed that documented for the next surgery so the next guy could possible fix it. She didn’t document it. I guess my question would be is that part of the laryngeal nerve? If so any suggestions on what to do about it?

wgreenlee
Participant

May 6, 2017 at 7:15 pm

Post count: 53

in reply to: ACDF Post-operative Concerns with CT-Scan results #24738

I also wanted to let you know I appreciate your input very much. If I could I would travel out there and let you preform the second surgery. I’m not very secure with any local guy’s.

Thank you again

wgreenlee
Participant

May 6, 2017 at 2:27 pm

Post count: 53

in reply to: ACDF Post-operative Concerns with CT-Scan results #24737

Have you ever heard of a surgeon performing a 2 level ACDF in that time frame? It seemed odd to me as well. The other part was the follow-up visits. The longest visit I had with him was 1:46 seconds. The last visit I had I had to call his office to schedule the 6 month to see if the fusion even had fused. At that visit as I was sitting in the chair with feet planted on the ground he did a reflex test by tapping below my knees. Is that normal? It seemed to me to be difficult to get a reflex if the patients feet are flat on the ground. Also I wanted to thank you for giving me a honest opinion.

wgreenlee
Participant

May 6, 2017 at 8:19 am

Post count: 53

in reply to: ACDF Post-operative Concerns with CT-Scan results #24734

Hello Dr. Corenmam,

Trying to figure out what was actually done in the hour and 17 minutes that I was cut open. Pre-surgery MRI states.

C5-6: Moderate posterior disc osteophyte complex asymmetric to right. Central Canal stenosis with residual AP canal diameter of 7mm. Right greater than left uncovertebral joint facet joint degenrate spurring with bilateral neural foraminal stenosis.

C6-7: Large posterior disc osteophyte complex with central canal stenosis and cord compression. There is complete effacement of the surronding cerebrospinal fluid. The residual AP canal diameter is approximately 6.5 mm. Bilateral uncovertebral joint facet joint degenerate spurring with bilateral neural forami al stenosis.

Post-operative MRI

C5-6: Large marginal osteophytes protrude posteriorly on the right side, making contact with the spinal cord and slightly displaces it the left side. Moderate-severe bilateral Nueral Foraminal stenosis. DJD of bilateral facet joints.

C6-7: Uncovertebral joint spurring causes mild-moderate bilateral Neural Foramina stenosis. Marginal posterior osteophyte causes mild-moderate narrowing of the central canal and making contact with the cord.

I also would like to add a MRI that was done by the VA in 2012. The first 2 MRI’s were both in 2015.

MRI cervical spine: Asymmetric disc protrusion is seen to the right C5-6 cord indentation and compression of the right C6 nerve root.

I have been back to the original surgeon and the only response I have gotten is that you have a lot of arthritis in your neck. This was after the post MRI.

The questions I would like your feedback on are as follows:

1) The surgery for a 2 level ACDF took one hour and seventeen minutes. Would this timeframe suggest that the surgeon opened the neck and put the distractors in the vertebrae and then put a plate and six screws in without removing the disc and clearing osteophytes anx foramina? Is that at all a possibilty?

2) The above information from the MRI’s clearly indicate in my view that the bare minium was preformed in this procedure. How could one show that this surgery was not as it is indicated on a post-operative report? By the way the post-operative report indicates the surgery was succesful foraminotomy was preformed and all nerve roots and dura was well decompressed. Osteophytes anterior and posterior were drilled with a midas drill.

3) Is it possible for the central canal to widen by only putting in distractors to pull apart the vertebrae to get more height and make a 1 to 3 mm difference in width size of the central canal?

I look forward to your answers and hopefully your input will verify what I believe actually happened.

wgreenlee
Participant

May 5, 2017 at 4:26 pm

Post count: 53

in reply to: ACDF Post-operative Concerns with CT-Scan results #24732

After a uncomplicated ACDF of C5-7 should there be cord contact, moderate-severe NF Stenosis, and cord dislocation? Symptoms currently are worse than before with added issue’s. Such as burning in shoulder blades, loss of feeling in pinky and finger next to it, headaches, and finally swallowing. First bite always gets stuck in throat either it comes back up or it eventually goes down and I get hiccups. I had a modified swallow test and they said that the muscle that controls the esophagus is hitting the metal plate. Anyway with these symptoms 2 years following surgery that was uncomplicated do you think I need to go ahead with a 2nd surgery? I had one surgeon tell me that he would make sure I get all the screws and metal plate after the corpectomy. Just not really thrilled about a second surgery since the impression from the first one was that everything went uncomplicated.

wgreenlee
Participant

May 4, 2017 at 10:24 am

Post count: 53

in reply to: ACDF Post-operative Concerns with CT-Scan results #24724

Dr. Corenman,

I have a quick question in regards to a MRI Report. In the report it states that There is a Anterior Discectomies with plate and screws at C5, C6, C7 also with secondary metallic artifact. I was curious what does secondary metallic artifact mean? Any help would be greatly appreciated.

Thank you,

Bill
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Viewing 6 posts - 19 through 24 (of 49 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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wgreenlee

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