In November 2018 (at 46 yo) I came from Vancouver BC to have a pars repair with Dr. Donald Corenman at the Steadman Clinic in Vail Colorado. I'm posting this review nearly 3 years later in late 2021 because I wanted to know the result before I posted my review. Unfortunately in that time Dr. Corenman has retired. Nevertheless, I want to post this review thanking Dr. Corenman and his staff at the Steadman Clinic for their excellent treatment of my L5 pars interarticularis.
I fractured my pars at age 42 in 2014 rolling on the gym floor, and was denied treatment by the Canadian healthcare system. First my GP said incorrectly there was no surgical option for a pars defect. The symptoms then worsened (periodic spine slippage and weeks of resultant pain after bending over, so I learned to squat and hardly bend). When I 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 martial arts (including jiu jitsu) for years prior to injury, as well as 5 years of reinforcing steel full time in my 20s. No pars defect would 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 (SBO) that made me more susceptible to a pars fracture. Due to my 2014 injury, I had a unilateral L5 pars defect, otherwise known as spondylolysis. I resolved to have surgery. If Canada's "universal health care" said no, I would find the very best surgeon in the world at pars repairs. That was Dr. Donald Corenman. Dr. Corenman ran a website https://neckandback.com/ that dedicated many pages to every aspect of pars repairs, from eligibility (good discs on MRI), surgical techniques (minimal open compared to minimally invasive), imaging (i.e., O-Arm with Stealth imaging vs. older fluoroscopy), ideal amount of BMP to use and why not use too much or too little, and much more, pages upon pages of his site just on pars repairs, with scientific references and his own expert opinion. This 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 at the time of surgery in 2018, with a 4 yo pars fracture from 2014 plus a congenital SBO meant my pars fragment was somewhat atrophied, but it was "very solid", said Dr. Corenman in the operative report. He fixed the pars, plus fixed the SBO at no extra charge! 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 offered nutritional advice as well, and answered many questions I had during months of recovery, with responses from the supportive Lori Fugate (then director of Dr. Corenman's practice), and Ehrich Bean (then physician's assistant [PA] at the practice), as well as a couple calls with Dr. Corenman 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. My final post-op CT scan was at 34 months post-op, and Dr. Corenman had retired, but I got a positive and informative call from Eric Strauch (current PA at the Steadman Clinic 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 add, 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, numerous x-rays when I felt something was amiss, as well as booking all four of my post-op CT scans.
My final scan 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" (HUGE) air conditioners up several flights of stairs by 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, my friends and family, Dr. Donald Corenman, Lori Fugate, Ehrich Bean, Eric Strauch, and the Steadman Clinic, as well as the Canadian spine surgeon who offered excellent post-operative care back in Canada. You have all given me a new lease on life.
Sincerely,
Eric S. read more