Back pain is a leading cause of disability in older adults, and studies show that a significant percentage of those with chronic severe back pain report mobility problems and work limitations.
Most people can trace their pain back to a specific moment, said Amy Still, APRN, a nurse practitioner at 泫圖弝け of Utah 泫圖弝け. The overwhelming majority will say, I did this movement, and then it occurred.
For Jim Foster, the moment came while working out in his home gym.
It was 2021, and Foster, a retired basketball coach who was 72 at the time, had just moved to Utah to be closer to his son and his sons family. Not long after relocating with his wife, Donna, Jim hurt his back lifting weights.
Something twisted the wrong way. After that, I had trouble carrying things, going up steps, and walking in general.
It turned out that Foster had herniated a disc in the lumbar (lower back) region of his spine. For the most part, though, the pain was concentrated in both his hips. This is common with herniated discs, where a fragment of the disc breaks off and pinches a nerve. This causes excruciating pain that often spreads from the lower back into the hips and legs. While age-related wear and tear, hereditary risk, and lifestyle choices can all contribute to disc herniation, most arise from movement-specific injuries like Fosters.
Foster called an acquaintance who had worked as an anesthesiologist in Utah. She gave me some names, and Dr. Mahan was at the top of the list, he said.
Mark Mahan, MD, FAANS, a spine and peripheral nerve surgeon at U of U 泫圖弝け. Right away, the level of comfort I felt with him was terrific, Foster said. I was just so impressed with everybody in his office. And whenever Donna had questions, Dr. Mahan didnt hesitate to answer them, which made her feel very comfortable.
Ultra-minimally invasive approach
Mahan, whos also an associate professor of at the Spencer Fox Eccles School of Medicine at the 泫圖弝け of Utah. offered to perform endoscopic surgery to fix Fosters herniated disc and alleviate the painful nerve. The ultra-minimally invasive procedure involves removing the disc fragment through a tiny 7-millimeter incisionabout the width of a pen. Within minutes, Mahan was able to remove the herniated disc fragment, immediately relieving nerve compression and Fosters pain. More importantly, by operating with a camera and specialized instruments, all of the spine musculature remained intact, minimizing risks and speeding recovery.
It was the first of five endoscopic surgeries Mahan would perform on Foster over the next three years.
With endoscopic surgery, all the work is done inside, said Still, who has worked closely with Mahan for more than a decade. This approach reduces risks of infection and muscle damage, shortens the duration of a patients hospital stay, and minimizes post-surgery pain and recovery time.
Endoscopic surgery also eliminates the chance of post-laminectomy syndrome, a condition characterized by persistent pain, often in the back, neck, or extremities, after undergoing spinal surgery. In traditional spine surgery, the disc is taken out, but the patient is forever changed because of the surgical approach, Mahan said. Thats the reason why I switched to doing surgeries endoscopically, because thats the way I would want to take care of myself or my family.
The challenge with endoscopic surgery is that its technically harder and requires more training and more specialized sets of tools. But for Mahan, the only surgeon at 泫圖弝け of Utah Hospital who performs endoscopic surgeries and the only one in the region who performs the highly advanced surgeries that Foster needed, the additional training has been worth it.
I was apprehensive going into surgery and getting knocked out, but then I woke up, and boom, its taken care of. The pain was gone, Foster said. Dr. Mahan and his staff just exude confidence in you as a patient. You just feel as though everything is going to be good. Its a great feeling.
Just the beginning
Not even a year later, Foster injured himself again, this time lifting a crate out of his car. All of a sudden, my back popped in another spot, he said.
Recurrence of疹ow畜ack pain疳s very common, with more than two-thirds of individuals having a recurrence within 12 months after recovery. This time, though, the pain was worse, and the injury more debilitating.
It was miserable, Foster said. I couldnt stand straight. Walking was difficult, even with a cane, as Id have to bend over 90 degrees. I remember lying in bed in the morning, psyching myself up to swing my legs out of bed and try to stand.
Mahan performed another minimally invasive surgery, fusing two vertebrae in his neck.
I knew Dr. Mahan would be able to help. I had complete trust in him and his team to take care of this new injury.
Again, the results were immediateno pain and minimal recovery time.
Recovery was easy because the source of the pain was removed, Foster said. So, then it was about physical therapy to strengthen muscles in the area that hadnt felt right because of what had been going on.
An endoscopic surgery to correct cervical nerve root compression followed, as did an endoscopic surgery to address carpal tunnel syndrome, a peripheral nerve disorder in which a nerve outside of the spine becomes pinched or compressed. Mahan is one of the few surgeons in the Mountain West region who operates on both spinal cord and peripheral nerves.
Jim benefited from our ability to seamlessly handle all of these issues, Still said. Very few spine surgeons will also do a peripheral nerve surgery like carpal tunnel. But it can be very helpful for continuity of care and having a full picture of how injuries may be interrelated that you wouldnt get by referring a patient out to another surgeon.
Pain-free
More than a year out since his last surgery, Foster continues to be pain-free. His walking, arm mobility, and hand strength have all improved significantly.
Theres a big difference between pain and pain-free, Foster said. Theres also a big difference when you can stand up on your own without assistance, without a cane or a walker, and you can actually do it the way youve always done it. Im not going to run any marathons, but Im incredibly thankful every day I can get in and out of bed, I can get out of the chair, I can turn and see one way or the other. I mean, its night and day.
