Story by: Sara Thompson on September 14, 2021
Minimally invasive spine surgery with less downtime than traditional surgery may sound impossible, but as Anne Douglas will tell you, it was a lifesaver for her. Anne, a retired internal medicine physician, experienced back pain for almost a decade before turning to more intensive therapies.
For years, Anne tried various measures to relieve her back pain.
“Things were getting progressively worse. I tried nonsteroidal anti-inflammatory medication, physical therapy, massage therapy,” she said. “Sometimes I just kept going, thinking if I ignore it long enough it will go away.”
A busy mother of three with a thriving medical practice, Anne didn’t like the thought of the downtime that back surgery might entail.
“I saw a pain management specialist for about two years, and that helped quite a bit,” Anne said. “He really got me through some tough times.”
Epidural injections and a noninvasive procedure called a rhizotomy (where some of the problematic nerves in the spine are destroyed) helped for a time, too.
But in 2019, things got bad enough for her to seek further attention for the pain. Anne’s regular routine was seriously affected, including her ability to exercise and stand for any amount of time without terrible pain in her legs and lower back.
“That’s when I knew it was bad, when I had to stop in the middle of a workout,” she said.
She was referred to Charles H. Crawford III, M.D., orthopedic spine surgeon with Norton Leatherman Spine.
A magnetic resonance imaging (MRI) scan and spinal evaluation showed Anne had degenerative disc disease, spinal stenosis and spondylolisthesis. Degenerative disc disease is a condition where the soft tissue between your vertebrae begins to dry out and shrink. This makes the spine less stable and decreases flexibility. Spinal stenosis occurs when the tube that holds the spinal nerves gets narrower. This can be caused by a number of issues, including tumors and bone spurs. Spondylolisthesis is a condition that happens when one of the vertebrae slips out of place onto the vertebra below it.
Degenerative disc disease runs in Anne’s family, and the other two conditions sometimes occur along with degenerative disc disease because it makes the spine unstable. Other factors include age, genetics and injury to the spine.
After a non-fusion surgery in 2019 Anne felt better for a while, but the pain came back, along with more troubling symptoms including difficulty with proprioception (balance).
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“I started to have a lack of awareness of where my legs were in space, if that makes sense,” she said.
Uneven surfaces became hazardous with this new symptom.
Another MRI showed the spondylolisthesis was putting more pressure on the spinal column. Dr. Crawford recommended a spinal fusion.
“I was reluctant to do the fusion,” Anne said. “I’ve known people who had this procedure and continue to have pain. It didn’t go well.”
She also was put off by the three-month recovery period.
“You can’t do anything. You can’t bend or twist.”
Anne realized she couldn’t do anything now anyway — the pain kept her from living her life. She agreed to the fusion surgery.
In September 2020, Dr. Crawford performed a minimally-invasive spinal fusion. This surgery involves making small incisions through which the instruments are guided. The surgeon then applies bone grafts between the vertebrae and stabilizes them with screws or rods. Anne noticed the difference immediately.
“I didn’t have those shooting pains in my legs,” she said. “When I could go for walks, the uneven surfaces weren’t a problem anymore.”
After three months, Anne started doing more of her regular activities plus adding some new things such as pickleball.
“The only thing you can’t really do is a lot of twisting and lifting,” she said.
She has been steadily building strength and mobility and is getting back into running.
The two pieces of advice Anne has are to consider pain management and get a second opinion.
“I think pain management gets a bad rap, but it really can help in some situations. If someone starts talking about surgery, get a second opinion. But if you need surgery, you need surgery.”
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