Donald Corenman MD DC | Spine Surgeon Colorado

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wmiller
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April 2, 2021 at 3:24 pm

Post count: 30

in reply to: Imaging 7.5 months post fusion #33888

Thanks. Below is what my MRI shows. They have ordered an ESI for the pain I have in my leg (I also have back pain). I apparently had this scar tissue six months ago (2 months post op), and I did not have these symptoms then. They have only come up in the last six weeks. This has me worried about lack of fusion, but my surgeon’s PA has told me that my x rays look perfect and so I don’t need a CT scan?

Report
At L4-5, there is no change in a very small broad central disc
protrusion, also associated with an annular fissure at the posterior
midline. There is no nerve impingement or significant stenosis.
At L5-S1, there is no change from prior, compatible with successful
fusion surgery. Fairly extensive epidural enhancing scar tissue is
again noted adjacent to the right S1 nerve sleeve with no change in
its appearance.

IMPRESSION:
1. Stable findings from MRI six months ago with findings of prior
anterior discectomy and fusion as well as posterior spinal fusion at
L5-S1. There are no findings to suggest significant postoperative
complications.
2. No significant spinal stenosis or nerve impingement identified at
other lumbar levels. Findings of mild disc degenerative change and
small broad central protrusions again noted at L3-4 and L4-5.

wmiller
Participant

March 28, 2021 at 3:29 pm

Post count: 30

in reply to: Imaging 7.5 months post fusion #33829

Sorry that should say I struggle to understand how I *could have*

wmiller
Participant

May 2, 2020 at 6:49 pm

Post count: 30

in reply to: six week post op concerns #32487

Thanks–symptoms got worse on Thursday and my surgeon ordered a standing extension/flexion x ray, which I had done on Friday.

If my operated segment was L4/L5, and I developed a slippage and subsequent foraminal stenosis, would the L4 slip over the L5 or would the L5 slip over the S1? My symptoms feel a lot like pre op, which involved my L5 nerve. I’m struggling to understand how a possible slip, as he explained, could bring back my original symptoms?

wmiller
Participant

April 12, 2020 at 8:38 pm

Post count: 30

in reply to: Resuming spin class post laminectomy #32434

Okay–yes, my surgeon told me I have just one strike left and I’ll be fused. But the side with two discectomies is not as flared up as the other side that just had the laminectomy without discectomy…could the healing of the repeat discectomy one impact the healing of the level above on the other side that was jut decompressed? Sorry for so many questions–I do not see my surgeon for another month (assuming that all this covid stuff has been resolved).

wmiller
Participant

April 12, 2020 at 7:22 pm

Post count: 30

in reply to: Resuming spin class post laminectomy #32431

Thank you so much.

So having two levels done at once, even if one did not involve a discectomy, can make healing take longer? No one has told me this and I was wondering why it seemed more difficult than my initial discectomy, which was done on a VERY large HNP.

Could the ike flare it up for >24 hours? I rode 20 minutes yesterday and as I sit here typing have pain on the left (laminectomy only) side radiating from glute to lateral leg.

wmiller
Participant

April 9, 2020 at 7:04 pm

Post count: 30

in reply to: foraminal stenosis #32417

Thank you. My neurosurgeon looked at the images, and he doesn’t see any nerve impingement there. I have had multiple MRIs over the past two years and it always shows up at L5/S1 as either mild or moderate foraminal stenosis without impingement, and on my most recent “slightly worsened foraminal stenosis compared to prior study but there remains no nerve impingement.”

A couple of follow ups (and thank you so much!!):
-You can have stenosis read as “moderate” but it still not impinging? Is the most important thing not the “mild” or “moderate” but whether it’s impinging?

-My surgeon told me that my disc is collapsing there at L5/S1, and it has been slightly worsening over time (I’m 37). Is it just a matter of time before it does impinge? He told me to avoid things I already am: don’t smoke, don’t be overweight, avoid high impact activities. Is there anything else to be done to prevent it?

-I have had a Right L5/S1 emergent discectomy after a bad fall down stairs, and nine months later had a revision discectomy there due to moderate reherniation, plus Left L4/L5 laminectomy for lateral recess stenosis. If I should continue to have issues with stenosis, at what point do I need to consider fusion? Since my fall, I feel like I’m just going surgery to surgery.
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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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wmiller

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