John Grossmith, MD, board-certified neurosurgeon at TBSI, is very familiar with patients who suffer with failed back. “Many of these patients have been told by other specialists that nothing more can be done to relieve their pain,” Dr. Grossmith says. “I have helped many patients who have had a variety of spine procedures and who have been told that nothing more can be done and that they will have to learn to live with the pain. Many other patients report that they were told that their post-operative imaging studies didn’t show any problems, or that their spine fusion ‘looked good’ and that no further surgery was indicated.”
At TBSI, the surgeon’s sole focus is to localize the source of the patient’s pain. After a thorough history, physical exam, and careful review of the patient’s imaging studies, 90% of these patients have a surgical problem, which can be treated by the Bonati Spine Procedure. “It is important to remember that imaging studies have resolution and three dimensional limitations,” says Dr. Grossmith. Frequently the images do not show the areas of spinal cord or nerve compression that are causing the patient’s pain.
Dr. Grossmith gives the following examples of failed back patients who benefited from surgical intervention based on a thorough history and physical exam.
Case #1: A 50 year-old man survived a plane crash 25 years ago. For years he had suffered debilitating low back pain. Past interventions provided no relief. Multiple imaging studies had been taken over the years, and all of his providers told him that his images had no findings requiring surgery. Dr. Grossmith localized the pain to the left L4/5 facet complex. The lumbar MRI showed subtle dark lines in the facet complex. During surgery, a partially fractured facet complex was removed. Intra-operatively, the patient tearfully reported that his 20 years of back pain had ended.
Case #2: A 40-year old woman with back pain was anxious about having another fall as she described episodes of having her “leg give out.” On physical exam, the patient had obvious quadriceps weakness. Her lumbar MRI showed some narrowness at the level of the L4 foramen which was not considered significant when she was evaluated at other institutions. The intra-operative finding at the mid L4 foramen was adherent synovial tissue with compression of the L4 nerve root. After fully decompressing the nerve, the patient’s motor strength dramatically returned to normal.
The Bonati Spine Procedure was able to help both of these patients.
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