degenerative disc disease
Athletic, optimistic and brimming with energy, Lisa is not one to complain or put her work aside because of a few minor aches and pains. Or even a few major ones.
“I had four children through natural childbirth,” Lisa says. “I didn’t want an epidural; I didn’t want them sticking a needle in my back.”
So when back pain crept gradually into Lisa’s life, she lived with it. It was occasional pain at first, then chronic. “I dealt with it,” Lisa says. “I thought, ‘I can do this. I can get through this.’ ”
And for many years she did. She took more breaks when doing yard work or standing on a ladder; she stopped jogging; and she walked around, stretched, and squatted during the countless baseball, basketball and football games that her children played. She worked hard not to think about her pain, even as it became more and more a part of her life.
Eventually, when simply walking had become difficult, Lisa realized that the pain was not only altering her physical behavior, it was also making her irritable and prickly to be around. Worried that she might end up crippled or in a wheelchair, she reached out for medical assistance. She visited a chiropractor, who did what he could for her, ordered an MRI, and referred her to the Mayfield Clinic.
As a referred spinal patient, Lisa came to Mayfield’s attention through Priority Consult, a special portal that enables Mayfield’s specialists to assess a situation quickly and speed the patient along the most optimal road to recovery. A Mayfield neurosurgeon sent Lisa to a neurologist, who tested her right leg for nerve damage, and prescribed eight weeks of physical therapy in the event that surgery could be avoided.
When therapy failed to improve Lisa’s condition, Lisa sat down face to face with her neurosurgeon, Dr. William Tobler, to discuss her options. At age 47, she was suffering from advanced degenerative disc disease. With little or no cushioning disc material between two of her lower vertebrae, she was feeling the withering pain of bone on bone.
Lisa was fearful of spine surgery, but then Dr. Tobler said two words: outpatient surgery. Lisa could hardly believe her ears. Because of a new minimally invasive fusion technique that was appropriate for her condition, she was a candidate for outpatient spine surgery. Dr. Tobler told her he could correct the problem in her low back and, most likely, she could go home the same day.
“When he said outpatient back surgery, it lit a light bulb in my head,” Lisa says. “He laid out my options and said I was a candidate for it. I thought, this sounds interesting. Then, when I started to read about it, I thought, this makes sense. It looks like a solution for what’s going on with me.”
Dr. Tobler told her he would employ a procedure known as Axial Lumbar Interbody Fusion, also known as AxiaLIF®, to treat her. The procedure is the least invasive approach to the lumbosacral region, which comprises the fifth vertebra in the lower (lumbar) spinal column (L5) and the first vertebra in the sacrum, or tailbone (S1).
The minimally invasive spinal fusion requires two small incisions, each less than one inch in length (one near the top of the buttock and a second in the back, just above the belt-line) and utilizes long, narrow instruments that are inserted through a small tube less than one-half inch in size. “The objective is to fuse this lower segment of the spine in patients who suffer from degenerative disc disease or spondylolisthesis,” Dr. Tobler says.
The operation, which fused Lisa’s L5 and S1 vertebrae, lasted one and a half hours and took place at the Christ Hospital Spine Institute in July 2007. There were no complications. During the procedure, Dr. Tobler removed the diseased disk material, then filled the space with a bone graft made from Lisa’s own bone and a synthetic gel. He then fixated the spine with screws. One screw, in the front, crossed and stabilized the two vertebrae, while two tiny screws anchored the back.
When Lisa opened her eyes in the recovery room, she looked up at her husband and told him, “The pain is gone.”
Lisa was on her feet before noon and on her way home 10 hours after arriving at the hospital. For the next several weeks she wore a back brace to provide support while the graft healed.
“She took a small amount of medication for a short time after the surgery, and now takes none,” Dr. Tobler notes. “The CT scan of her spine one year after surgery shows a solid fusion in the area treated.”
Today Lisa is living with no restrictions. She works out three times a week, goes for rapid walks, and enjoys her children and their activities. She can play golf, go horseback riding, and hold her own with her son on the tennis court.
“I’m a miracle,” Lisa says. “I want to get the word out that there are things you can do for terrible back pain. There is no reason to be stubborn. The joy of life is back. My joy is back.”
Hope Story Disclaimer -"Lisa's Story" is about one patient's health-care experience. Please bear in mind that because every patient is unique, individual patients may respond to treatment in different ways. Results are influenced by many factors and may vary from patient to patient.
updated April, 2012
“When the pain is ruining your life, when you’re hurting every waking moment, you know life should not be like that.”
a working tunnel is created between
the bony sacrum and the pelvic organs
to access the 5th lumbar vertebra.
The diseased disc between L5 and S1
is removed and a screw is inserted
to fuse the bones together.