Situation
J.H. is a 59-year-old government agent who
had a long history of back pain that began with a work-related injury in the 1970s.
He obtained X-rays years ago that showed a slippage of the fifth lumbar vertebra on the
sacrum (Figures 30 A&B). The medical term for this condition is an L5-S1 Grade I
Spondolytic Spondylolisthesis.
A. X-ray
B. MRI
Figure 30. X-ray (A) and MRI (B) showing Grade I Spondolytic
Spondylolisthesis, or slippage of one vertebra past.
He had spoken to several surgeons in the past
who recommended a back operation using screws to stabilize the area, but the patient was
discouraged from surgery because he was told that results were modest to poor.
Also, the operation didn't make much sense to him because it would not correct the
slippage. He tried physical therapy, acupuncture, water therapy, and bracing, with
very little relief.
Treatment
In 1998, J.H. was referred to Dr. McCormack
by his local neurosurgeon. Dr. McCormack explained that new technology had developed
that now enable the surgeon to actually correct the deformity. Furthermore, the
operation could be performed through the abdomen with small incisions and scopes similar
to those used for knee arthroscopy. Surgery went without difficulty, and X-rays
showed almost complete correction of the slippage (Figure 31).
Figure 31. Post-operative X-ray shows reduction of the L5-S1 slippage
by cages filled with the patient's own bone.
The patient had excellent relief of his back
pain after surgery.
Patient Comment
"Dr. McCormack explained an operation
that finally made sense to me. I did my homework in finding information about my
problem. I'm glad I did...my back feels great!"
First case
Copyright the Neurospine Institute 1998.
Last edited 09/11/98.
