Case Studies
Graceful Recovery: Tailored Spine Surgery in the Older Adult
An 83-year-old woman came to me with severe lower back pain that made it hard for her to stand or walk. She was truly miserable. She had already tried physical therapy and epidural injections without relief, and had seen several other surgeons who told her she wasn’t a candidate for surgery because of her age.
But all she wanted was to be able to stand and walk with her grandchildren and attend church again.
After carefully reviewing her case, I recommended a minimally invasive surgery to relieve pressure on the nerves in her lower back (a two-level MIS decompression). The surgery took about two and a half hours.
She went home the next day and had a noticeable improvement in both her back and leg pain. By three months after surgery, she was doing very well and thrilled with her progress.
Age alone should never be the reason to deny someone the chance to feel better. With the right approach, even older adults can benefit from surgery when it's done safely and thoughtfully.
From Hopeless to Healing: Advanced Imaging Leads to Targeted Spine Treatment
A 47-year-old retired veteran came to us with severe, ongoing lower back pain that had not improved despite trying many treatments—including physical therapy, steroid injections, and even a spinal cord stimulator. He had seen several surgeons before, all of whom told him that there were no surgical options available.
Wanting to take a closer look, we ordered a specialized scan (called a CT-SPECT scan), which showed that the L5-S1 disc space in his lower spine was likely the main source of his pain.
He underwent a surgical procedure called an anterior lumbar interbody fusion (ALIF) to stabilize that part of his spine, followed by the placement of screws through small incisions in his back to support the area.
He went home three days after his surgery and did very well in recovery. Since the procedure, he has had a significant improvement in his back pain and overall quality of life.
Minimal Downtime, Maximum Relief: A Working Professional’s Spine Surgery Success
A 56-year-old woman came to us with serious lower back pain and pain that radiated down her legs. After imaging studies, we found that one of the bones in her lower spine (L4) had slightly slipped forward over the one below it (L5)—a condition called grade 1 spondylolisthesis.
To help relieve her symptoms and stabilize her spine, she had a minimally invasive surgery called a lateral interbody fusion at L4-5, along with the placement of screws through small incisions in her back (percutaneous instrumentation). The surgery took about four hours.
She stayed in the hospital for two days and recovered quickly. Within two weeks, she was back at work. Her incisions healed well, and her back pain had greatly improved.
Balancing the Spine, Respecting the Patient: A Thoughtful Surgical Choice
A 63-year-old woman came to me with severe lower back pain that had persisted despite several previous spine surgeries. Just the year before, she had undergone an additional spinal fusion by another surgeon, but unfortunately, it hadn’t helped—and she remained in constant pain. She had tried all the non-surgical options available, without relief.
After reviewing her imaging, medical history, and physical exam, I discussed two possible surgical approaches with her: one was a more extensive reconstruction of her entire thoracolumbar spine, and the other was a more limited procedure. Understanding the trade-offs, she chose the less extensive option, wanting to preserve as much mobility as possible.
We performed a four-level transforaminal lumbar interbody fusion using expandable cages—special devices that helped correct her posture and restore the natural curve in her lower spine (flat back deformity).
She spent three days in the hospital and, by her six-week follow-up, was standing upright with a major improvement in both her back pain and posture.
This case highlights one of the most important principles in my practice: taking a personalized, patient-centered approach to care and helping patients choose the right solution for their unique situation.
A Long Road, A Strong Recovery: Complex Spine Surgery Done Right
A 74-year-old man came to me with severe, ongoing back pain that had left him nearly disabled. He had already had several back surgeries in the past, including procedures to relieve pressure on his nerves and to fuse parts of his lower spine. Unfortunately, his pain had returned and continued to worsen.
X-rays showed that his spine was leaning forward significantly—a condition known as flat back syndrome or sagittal imbalance. This abnormal posture was causing constant discomfort and making it hard for him to stand upright.
He had tried everything from physical therapy to medications, but nothing worked. After discussing his options in detail, we decided to move forward with surgery.
He underwent a complex spinal reconstruction, which included a fusion from his upper back (T10) down to his pelvis, along with a procedure called a pedicle subtraction osteotomy to realign his spine.
He spent about a week in the hospital, followed by two weeks in a rehabilitation center to help regain his strength. By three months after surgery, he was standing much taller and reported a significant reduction in his back pain—and a major improvement in his overall quality of life.
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