Brooke — Louisville, KY
"I had been living with progressively worsening back pain for several years, the result of vertebral stress fractures I incurred as a cheerleader in high school. As summer approached, as much as I had enjoyed working with my students, I was sure my first year of teaching would be my last, as my back pain had become nearly unbearable after a year of standing and walking around all day.
"I also was discouraged because my doctor advised me to not have children with my vertebrae in the shape they were in. Pregnancy is tough on a woman's back even when her bones are healthy, and considering the condition of my two spinal fractures and their location—in two of the lumbar vertebrae in my lower back—carrying a pregnancy to term could have potentially done a lot more damage."
But today, because of a specialized spinal procedure that stabilized her vertebrae and eliminated her back pain, she has been able to resume her teaching career and is now looking forward to being able to start a family with her husband.
When Brooke's stress fractures were first diagnosed in high school, her physician at the time determined that the vertebrae were still stable, so for several years she was able to successfully manage the pain with an external brace, exercise and pain relievers. But when she started her teaching career after graduation, her pain flared back up.
"I was referred to Dr. David Rouben, who, after diagnostic MRI and X-ray testing, saw immediately that my fractured vertebrae had destabilized. The fragments curved inward, so whenever I leaned over, they could press on the vertebrae below and push the discs into my spinal cord or nerves.
"Dr. Rouben's opinion was that at this point, my condition had progressed beyond what was 'fixable' with conservative care, and that surgery was now my best option."
Brooke admits that she initially had reservations about undergoing spinal surgery. "The only type of spine surgery I was familiar with was open surgery, where you have a really large incision and longer recovery period, and I was not interested in that at all! But after Dr. Rouben told me about the procedure that he felt was right for me and my condition—a minimally invasive transforaminal lumbar interbody fusion, or TLIF—I felt much better about it."
"What was reassuring to me was that it was minimally invasive spine surgery, which means Dr. Rouben only needed to make several small incisions. I had four: two for each vertebra, on either side of the spine, and a couple of "snake bite"-type incisions above those, which I can't even see any more. Through these small openings, Dr. Rouben placed bone graft between each vertebra after removing the affected discs, relieving the pressure on the nerves, and then he stabilized each vertebra with two rods and four screws."
Brooke said Dr. Rouben also was careful to explain that in addition to the possible benefits of the procedure and the technology used to perform it, there also were potential risks. These include, but are not limited to, transitioning to a conventional open procedure early or late loosening of any or all of the components; disassembly, bending, and/or breakage of any or all of the components; and postoperative change in spinal curvature, loss or correction, height, and/or reduction. Additional risks include infection; foreign body (allergic) reaction to the implants, debris, corrosion products (from crevice, fretting, and/or general corrosion), including bone infection, staining, tumor formation, and/or autoimmune disease; and loss of or increase in spinal mobility or function.
Brooke was able to go home two hours after minimally invasive spine surgery, and started physical therapy a week later. Her back pain began to improve almost immediately. "Before surgery my pain was internal. I could tell something was wrong in my spine. After surgery, that pain was gone and the only thing I felt was some pain around my incisions, which lasted about a week and a half."
Brooke was soon able to resume many of her everyday activities. "After two weeks, I was doing laundry and cleaning the house. We're also an outdoors family—my husband and I have a cabin on the lake and we like to go boating, swimming and skiing. I didn't want to miss out, so I was really pleased when I asked Dr. Rouben if I'd be able to do any of these things and he said, "Well, it's safer for you to do them now than it was before."
I know each person's recovery is different—and I'm not saying that everybody's will be as quick as mine—but 3 weeks after surgery I was skiing around the lake, and by the next weekend, I was back on my Jet Ski. I was very happy I was able to be a 'normal person' that summer!"
Brooke is very happy she overcame her initial reservations about spine surgery and agreed to have the minimally invasive TLIF procedure. "Continuing to live in pain would have affected my life far beyond just the physical discomfort," she says.
"I probably would not be able to have the job I have now—teaching algebra and coaching the dance team at our school. Becoming a teacher has always been my dream, and it would have been really discouraging to have worked so hard for a college degree and not be able to use it. I just don't know what I would do if I couldn't do this.
"I also can't imagine not being able to have kids. I've always dreamed of having a family, and if I couldn't do that because I wasn't able to have surgery, it would have crushed both me and my husband.
"I feel so fortunate that Dr. Rouben was able to come up with the right treatment plan for me."
After reading this please keep in mind that all treatment and outcome results are specific to the individual patient. Results may vary. Complications, such as infection, blood loss, or nerve damage are some of the potential adverse risks of spinal surgery. Please consult your physician for a complete list of indications, warnings, precautions, adverse events, clinical results, and other important medical information.