Ten years ago, I was skiing off trail on a very steep terrain when I hit ice, which sent me tumbling backwards down the mountain and eventually hit a small tree. I was airlifted off the mountain and treated for injuries to my chest and a concussion. When I returned home from my ski trip, I resumed all my usual activities – biking, walking, swimming, kayaking, and taking care of the house and my family. Gradually, though, my back began feeling very painful and I was unable to continue certain exercises. I went to a doctor who told me my symptoms were primarily due to arthritis. I had some improvement in my pain after trying anti-inflammatory medication, injections, and physical therapy; eventually I was able to return to my active lifestyle.
Three years ago, I participated in a 62-mile hike, and around the 22nd mile I had excruciating pain in my back. I had to stop the hike and resumed conservative treatments of medications, physical therapy, and rest; nothing seemed to relieve my discomfort. At this point, I began considering surgical options. I sought opinions from three surgeons before meeting Dr. Brian Subach from the Virginia Spine Institute. He provided me with the most thorough consultation based on x-rays, surveys, and examinations. His advice was to offer me the best surgical option that would return me to the active life I’d always been able to enjoy. Dr. Subach recalls evaluating Susan Merry’s pain and recommending a fusion surgery.
“Her pain seemed to be worse in the morning, although it would loosen up during the course of the day. The pain was often severe enough to awaken her from sleep at night. Standing seemed to be worse, while sitting and lying on her side were somewhat better. Susan described 90% back pain and 10% lower extremity symptoms, mostly with numbness and weakness into the legs. Essentially all of the things that she enjoyed were difficult to perform secondary to the severity of her pain.
Her initial imaging studies, including x-rays and an MRI scan, demonstrated spondylolisthesis at both L3/L4 and L4/L5 levels with an obvious scoliosis posture leaning toward her left. The MRI scan showed severe spinal stenosis at the areas of spondylolisthesis as well as compression of the exiting nerve roots.
Based upon her scoliosis and her spondylolisthesis, I advocated a three-disc fusion. By taking out the disc spaces and replacing with a small wedge of donor bone, I thought I would be able to restore her posture, her alignment, and decompress the nerve roots all at the same time. The other surgical opinions had recommended a five-level fusion, which was more significant than I thought was necessary.
On June 20, 2012, Susan underwent a transforaminal lumbar interbody fusion at L2/L3, L3/L4, and L4/L5. In the areas of scoliosis I was able to use an osteotome to cut through the bone that was holding her into a misaligned position. By placing spacers into the disc spaces and then compressing the screws together, I was able to restore both her normal posture on side view and front view x-rays.”
Treatment & Recovery
Approaching the date of my surgery, I was pretty apprehensive about the lengthy procedure, but I took my doctor’s advice and continued to exercise as much as possible until the operation. During my recovery in the hospital, I wasn’t in any particularly bad pain. I was able to get up and do laps around the hospital floor almost immediately and once I was back home, I was able to go out for walks in the neighborhood and then go back to my gym at just two weeks after surgery.
Dr. Subach is thrilled with Susan’s quick and complete recovery.
“Prior to surgery, Susan rated her back pain and leg symptoms as a six on a visual analog scale of ten. At her one-month postoperative visit she had zero leg symptoms and zero back pain. With the size of the intervention and the corrections of both her side view and front view x-rays, it was amazing that she was feeling better rather than worse. She initiated physical therapy and began getting her strength and flexibility back. Her imaging studies demonstrated evidence of progressive healing and excellent correction of her scoliosis.”
It is one year out from surgery and I have absolutely no pain and don’t even take an occasional Advil. I gained back my lost two inches, skied this winter, kayak on Puget Sound, walking a lot, and back doing boot camps, stretch classes, etc. We just moved from the east coast to the west coast, packing up our house of 30 years. For four months I was (carefully)lifting boxes, reaching into the far recesses of the house, etc., and all with no ill effects. This surgery was nothing short of miraculous.