A community health education series from Stanford Hospital & Clinics
Restoring the Spine’s Natural Curves With New Minimally Invasive Surgery Just like most of us, Jerry Stark took his physical strength for granted until the first time it didn’t respond the way it always had—and delivered word of its new status with a sharply-sent message of pain. Stark had spent most of his working life as a house painter in Santa Rosa, crawling up ladders, over roofs, through attics. Often he was carrying full five-gallon cans of paint at the same time. It was hard physical work, but Stark didn’t think twice about it. “When you’re doing physical things all the time, you just keep doing them,” he said. “You never think you won’t be able to. It’s just what you do.”
Debilitating pain “When they asked me at Stanford what my pain level was—they go by numbers 1 through 10—I started with an 11,” Stark said. His spine was curving into an extreme S shape and sloping forward, too. Very little about Stark’s life was normal, especially since he needed so much medication for his pain that he felt drowsy most of the time. Work was out of the question. And small inconveniences symbolized his deterioration—the day arrived when Stark was so bent over he could no longer see his face in his bathroom mirror.
“I kept thinking, ‘You can exist this way. It’s not going to get worse.’ Then you look in the mirror and it is worse. And you know you have to do something about it.” – Jerry Stark, patient, Stanford Hospital & Clinics Norbert von der Groeben
Before the orthopaedic surgery that restored his spine to a more normal curvature, Stark lived with pain he counted as an 11 on a scale of 1 to 10. Now, he can stand straight enough to look himself in the mirror again.
Stark’s scoliosis, like that diagnosed in 6 million others in the United States, had no definitive cause, although genetics and biology may play some part. The abnormal curvature of the spine can appear at any time of life. With age, however, comes the natural degeneration of discs, the pads of cartilage that cushion the spine’s stack of bony vertebrae. Bone on bone grinding becomes one cause for pain; pinched
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Norbert von der Groeben
He figures it might have been about 20 years ago that he lifted something “and I lifted it wrong,” he said. “I dropped to my knees in pain and couldn’t get up.” After a few minutes, the pain was gone and he returned to work as if nothing had happened, he said. But many more years as a painter would exact a heavy toll. By the time he saw Ivan Cheng, MD, an orthopaedic surgeon at Stanford Hospital & Clinics, he had endured nearly 30 years of increasing disability from a spine that had degenerated into a twisted, bent version of its once-straight self and with it any semblance of a normal life.
Jerry Stark figures his back problems might have begun about 20 years ago when he lifted something “and I lifted it wrong,” he said. Decades later, adult scoliosis had altered his spine into a twisted, bent version of its oncestraight self, taking with it any semblance of a normal life. spinal nerves can send pain signals down through the legs. For many, medication and other nonsurgical treatments can alleviate the discomfort caused by scoliosis’ misalignment. For others, including Stark, the changes caused by the condition may require surgery. Until recently, such surgery was very risky and could mean months of hospitalization toward an end result that was not always positive. Stark, fearful, tried to ignore what was happening to his body. “I kept thinking, ‘You can exist this way. It’s not going to get worse.’ Then you look in the mirror, and it is worse. And you know you have to do something about it.”
former wife, Pam, who volunteered to be part of his post-surgical support team, along with his grown children, began to interview surgeons. At one facility, they waited four hours to see a surgeon; they liked him but were put off when, after presenting him with some questions, he directed them to his assistant. They decided they’d seek a second opinion at Stanford. “I think the longest we waited was
“Twenty years ago, there probably would have been a lot of reluctance to operate on Mr. Stark,” said Cheng. “Surgery for these types of spinal problems often took multiple procedures, staged over days, with massive blood loss and patients might lay in bed for six months at a time.”
New techniques—and hope What Cheng and other orthopaedic surgeons now have available are new, minimally invasive ways to enter the body and new implants endowed with technology that makes them more reliable. Stark and his
Before
After
(Left) Stark’s spine before his surgery. His scoliosis, like that million others in the United States, had no definitive cause, and biology may play some part. (Right): Stark’s spine after a more natural position with new, minimally invasive ways and new implants endowed with technology that makes th