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For Ann Pile, 57, long walks and bike rides are a joy, whether in Illinois parks, such as Starved Rock or Matthiessen, or around her own neighborhood in Plainfield. These pastimes had been out of reach for a long time thanks to a multi-year stint of back and leg pain.
By early 2014 the pain had become too excruciating to ignore.
"The pain started just above my right buttock and traveled down through my knee, landing in my right foot, along with a pins and needles feeling," says Pile. "Walking was painful, as was sitting or standing for too long. I couldn’t do much of anything."
Pile’s primary care physician ordered an MRI, which showed degenerative disease in the discs in her lower back. The cushion-like discs between spinal vertebrae act as shock absorbers. They help distribute stresses across the spine during movement and when a person is simply carrying his/her body’s weight. With age and/or injury, these discs can wear down, sometimes limiting movement and causing pain.
Pile began a series of conservative treatment options: short periods of rest, oral medications, epidural injections, chiropractic care and physical therapy. When these options didn't provide much relief, her doctor referred her to neurosurgeon Tibor Boco, MD, Medical Director, Neurosurgical Services, Elmhurst Hospital and a member of the Neurological Surgery and Spine Surgery group.
"Dr. Boco was very comforting," says Pile. "It was nice to have someone who understood my pain and knew what was wrong. He was thorough and explained everything."
Dr. Boco told her she had leg pain because as the disc degenerated, the space between the vertebrae shrunk, crowding the nerves that run down the leg.
A review of Pile’s imaging studies, symptom and treatment history led Dr. Boco to recommend spine fusion surgery, specifically a minimally invasive TLIF (transforaminal lumbar interbody fusion).
"At Elmhurst, our choice of surgical technique and tools for a particular spine surgery is based on a full assessment of the patient’s overall spinal alignment and balance, as well possible future spine problems," says Dr. Boco. "An added benefit of our holistic approach is this focus beyond the one disc level that’s causing symptoms. We know that restoring or maintaining spine balance is crucial to mitigating pain and disability during aging. And research indicates a direct correlation between spinal alignment and long-term patient outcomes."
On Aug. 24, 2016, Dr. Boco began Pile’s surgery with a small incision and then passed a small retractor through the incision until it rested on the spine. This created a passageway for delivering the surgical instruments and other equipment, such as screws, rods and a spacer to stabilize the spine.
"I removed part of the roof of the spinal canal to restore space around the nerves," explains Dr. Boco. "I also removed the entire degenerated disc. That empty space was then filled with a structural graft and the patient’s own bone that had been harvested from the roof of the spinal canal. Tiny screws and rods hold the vertebral bodies together until they have healed and fused. As a result, we maintained proper regional sagittal balance of the lumbar spine."
Soon after Pile’s three-day hospital stay, she began physical therapy. By six weeks after surgery she was virtually pain-free. The London-born mother of three says the care she received made her "feel like royalty."
The surgery itself, she says, changed her life.
"Before the surgery, I would cry frequently because of the pain. Now I have a smile on my face."
Get more information about spine surgery at Edward-Elmhurst Health.
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