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della's story ::: degenerative disc disease
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"I had some doubts that I'd be able to go back to my previous life, that I'd be able to go back to my job. But I feel so much better now. I'm lucky to be the recipient of hardware in my back."
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There was nothing simple about the cause of Della’s back pain, and there would be nothing simple about the solution. The chronic pain that made life impossibly difficult for Della was caused by complex, degenerative spinal conditions called spondylolisthesis and stenosis.
Della’s pain was not caused by any particular incident. It developed, rather, from decades of working as a labor and delivery nurse. Years of moving, and turning patients had taken a toll on her spine. Conservative treatments were administered, without success. “I took a lot of pain pills,” Della recalled. “I had three years of treatment with steroid epidurals. But there is a limit to how many epidurals you can have. I’d gotten to the point where I couldn’t work because of the pain.” Della needed more than just pain pills or even spinal epidurals. Her neurosurgeon, William Tobler, MD, of the Mayfield Clinic, proposed a minimally invasive surgical procedure, an operation that utilizes sophisticated technology and techniques to minimize the size of the incision. For the typical patient, a small incision results in reduced risk, reduced pain, smaller wounds, and a faster recovery than other methods. Using a new technique, Dr. Tobler performed a minimally invasive fusion, to stabilize Della’s degenerating vertebrae. During the procedure, the intervertebral disc was removed from the lower spine and replaced with a mechanical spacer that, acting as a fusion device, would assist in the growth of bone from one vertebra to the other. Pedicle screws were placed into the back of the spine and connected with rods to provide additional stability until fusion could take place. Dr. Tobler used the PathFinder System, manufactured by Abbott Spine, for precise insertion and placement of the screws. Bone graft from a cadaver was used to fuse the loose vertebrae and keep them from sliding out of place. Another important benefit of using a minimally invasive surgical technique to treat patients with spondylolisthesis is reduced time spent under anesthesia. While the typical open fusion usually takes three to four hours or longer to perform, Dr. Tobler has honed the minimally invasive fusion procedure to two to three hours. Della, whose medical condition presented unique challenges, was warned that she would face a long recovery, and she battled the pain for a full month. But two and a half months after the procedure, she considered herself fortunate “to be the recipient of hardware in my back.” Not only had her surgical pain disappeared, but the chronic, debilitating pain that made surgery necessary also had vanished. Her days of using a “wheelie-mobile” at the grocery store were behind her. She was able to return to work full-time. “I feel like a real person again,” Della said. “I don’t have any leg pain anymore. I don’t have any back pain anymore. Most days I can get through without a Tylenol.
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