Orthopaedics
Tina’s Story - Page 2
Isthmic Spondylolisthesis and Spinal Fusion Surgery
“Dr. Rubery put me at ease right away. He’s such a good listener. Before he tried to give me answers, he asked all the right questions. When it came time to deal with my options, he was upfront and honest. He didn’t paint a rosy picture. He explained the surgery, what could happen and the after care I’d need. All the advantages and the risks were outlined in terms I could understand. Then he let me decide. He didn’t push one way or another.”
“I decided to go ahead. It seemed to me that the risks of the surgery were no more ominous than what might happen if I didn’t get the surgery. It helped to know that he’d done this spinal fusion many times. I knew I was in good hands.”
In true Tina fashion, she asked Dr. Rubery to put the surgery off so she could pack a few more commitments into her schedule. But because of the pain, she realized she couldn't wait and booked the surgery. Today she couldn’t be happier that she did.
How did her spine get damaged? Tina wanted to know. Dr. Rubery explained that her condition is called isthmic spondylolisthesis and it occurs when one vertebrae slips forward on another because of a small fracture in a piece of bone that connects the two. The fracture is caused by stress to the bone and occurs most commonly when an individual is young (usually 8 to 10 years old, but sometimes in adolescence), although symptoms such as lower back pain and/or leg pain do not typically show up until adulthood. After it’s fractured, the bone isn’t strong enough to withstand the pressures of growing and everyday life. “Mom always said to stand up straight. I thought I was, but when I look back at photos I see I was bent forward at the waist,” Tina recalls.
The day Tina went in for surgery, she got a pleasant surprise. She says, “It felt like old home week. I knew a lot of the folks on the surgical team, including my anesthesiologist, because I’d taught their children over the years. They promised to take really good care of me and that meant a lot!”
It would be eight hours by the time Dr. Rubery completed Tina’s operation -- a long procedure, but necessary given the complexity of Tina's problem.
Tina’s surgical procedure is called a combined anterior and posterior spinal fusion. Her spine was first accessed from the front through her abdomen (the anterior part of the procedure). Vascular surgeon Karl A. Illig M.D. began the surgery by making an incision just above the pelvic bone. The organs in the abdomen, such as the intestines, kidneys, and blood vessels, were moved to the side to allow Dr. Rubery to see the front of the spine. Tina’s spine was propped up with a device that looked a bit like a lego and bone graft harvested from Tina’s hip was placed into the area between the vertebrae. It went well.