After 11 Years of Back Pain Following Accident, Woman Finds Relief in Neurosurgery for the Spine

• Backache • Aug 26, 09

Newport Beach resident Dorys Balboa spent 11 years in pain after being involved in a car crash that injured her low back. Medication, pain management techniques and alternative therapies, such as acupuncture, offered only limited respites, but decompression surgery performed by a neurosurgeon at Cedars-Sinai Medical Center brought immediate, complete relief.

“I came out of the recovery room and I remember I could move my feet again, and I couldn’t do that for a long time. My right toe had been numb and I’d had excruciating pain all the way up my leg. I couldn’t flex my foot forward and backward,” said Balboa, 41.

“When I got out of surgery, I was moving my foot and thinking, ‘I’m probably not feeling the pain because I’m still medicated.’ So I was trying to reason with myself not to get too excited. But I was thinking, ‘I can feel a little pressure on my back, and if I can feel that, I should be able to feel the pain in my foot.’ And then it just dawned on me: ‘Oh, my gosh, I am OK.’”

“She came in after seeing a couple of physicians in Orange County, and her clinical presentation was quite dramatic. She was in so much pain she couldn’t find a comfortable position. She was in tears and said the pain had made her a different person,” said neurosurgeon Burak M. Ozgur, M.D., director of Minimally Invasive Spine Surgery in the Department of Neurosurgery at Cedars-Sinai.

Balboa suffered from spinal stenosis at the lowest levels of the spine. This narrowing of the spinal canal and the spaces through which the nerve roots exit was made worse by a herniated disk. Together, these conditions caused several nerves to be pinched.

“She did have some significant nerve compression, but many times we will continue with conservative management, including pain medication, injections, and physical therapy. But when I examined her, heard her story and saw the films (MRI images), I thought she had already been through enough in terms of conservative management and trying to wait and see if this would get better spontaneously. This was a matter of making the right diagnosis and offering the right treatment to alleviate her symptoms,” Ozgur said.

He performed a decompressive laminectomy at two levels (between lumbar vertebrae 4 and 5 [L4-L5] and between lumbar vertebra 5 and sacral vertebra 1 [L5-S1]) on March 11. In this procedure, the portion of the vertebral bones called the lamina is removed, allowing the soft tissue of the canal to expand and free the nerves. Technically not a minimally invasive procedure, the surgery was performed through smaller incisions than those of traditional laminectomies. With new tools and techniques, the major muscles of the back are pushed aside rather than severed, allowing patients to resume their normal routines much more quickly than before.

“Immediately after surgery, I went back to my patient room and was walking within a half hour,” said Balboa, who owns a business specializing in interior design for home builders. “I had the surgery on Wednesday, saw the physical therapist on Thursday, and was ready to go home on Friday.”

She was able to walk and move normally the day she went home, and resumed all but her most strenuous activities within weeks.

Although Balboa’s back pain stemmed from the car accident that occurred more than a decade ago, it was exacerbated last August when she and her husband, Alan, decided to drive to Del Mar for an anniversary celebration. While unpacking upon arrival at their hotel, she bent down to plug in an iron.

“Our little trip came to a quick end,” she said. “We drove home for about an hour and a half and I literally crawled from our garage into our bedroom and did not see daylight for days after that.”

She had an acupuncturist come to the home and visited an orthopedic specialist for several months. She was hesitant to undergo surgery but said the pain was so intense and long-standing it affected her personality, and she knew she was not pleasant to be around.

While trying to decide what to do next, she read an article about Ozgur and neurosurgical techniques for the spine. It had been clipped from a national magazine and mailed to her by a lifelong friend who lives in Rancho Palos Verdes.

“The timing was amazing because I’d just gone through so much. I was at the point where they were doing pain management and giving me injections for pain, but it was just basically putting a patch on the problem. I was never going to get better,” Balboa said.

“I looked up Dr. Ozgur to see if he was covered under my insurance plan, and he was, so I made a phone call. That was on a Thursday. Tuesday I had an appointment with him, and the following Wednesday I was in surgery,” she said. “When I came out of surgery, there were tears of joy. I am a new person. My husband laughs because he said, ‘Honey, the old Dorys is back.’”

Source: Cedars-Sinai Medical Center