Spine Surgery

Hello Spain!

Gail Moser spine surgery patientSpirited flamenco dances and vibrant nighttime plazas beckoned. But heading into surgery at Milford Regional this past spring, Gail Moser had not committed to joining her sister’s family for a planned vacation in Spain; the reason… her lower back.

The veteran traveler first noticed a problem six years ago, during a visit to London to see her niece, then studying abroad. She walked more than usual, and a sharp pain eventually flooded down her right leg. “By the end of the day, my leg would just be throbbing,” the 66-year-old Medway resident says.

The discomfort went away with a little rest, so Moser attributed it to a lack of fitness. That led to a pattern: sometimes noticing the pain at home, then feeling it more intensely during her walk-heavy European trips every couple of years. She did not see a doctor. “You just assume that’s the way it is and there’s nothing you can do,” the technical writer says.

But a trip to Italy two years ago proved a particular challenge. She also started struggling more back home, needing breaks during walks and taking shortcuts on the trails surrounding her Northborough office. “The time I could walk pain-free was getting shorter and shorter,” she says.

That finally prompted a visit to her primary care doctor, where Gail described the sensation: a radiating ache that began in her right buttock, shot down her thigh and calf, and eventually numbed her foot. The diagnosis… spinal stenosis, which can narrow the space between vertebrae, the spinal cord canal or the gaps where nerves branch off. For Gail, the narrowing pressed the root of her sciatic nerve, causing pain that followed the nerve down her leg.    

Aging is a major cause of stenosis, with supportive tissues in the spine thickening and hardening, bones and joints growing, and bone spurs developing. Gail's condition was also exacerbated by a rupture in a disc cushioning her vertebrae and by age-related arthritis called osteoarthritis. Some people with stenosis never experience symptoms, but not Gail. Non-surgical treatments also did not work — physical therapy, anti-inflammatories, steroidal injections, electrical stimulation or ultrasound treatment.

So when her sister invited her to Spain, Gail hesitated. She dearly wanted to spend time with her family and see her niece, working in Madrid. But she didn’t know if she could handle the two-week trip.      Though wary of back surgery, Gail talked to colleagues who had good experiences with it. After researching her options, she saw a surgeon and got more scans. A desire for a second opinion brought her to Dr. Mitchell Hardenbrook, who directs the Advanced Spine Institute of Greater Boston and offers surgery at Milford Regional.

During their initial meeting, Gail noticed how he sat and looked her in the eye while talking and listening — something doctors had not always done in her experience.

She told him about her goals, including the trip to Spain. He recommended two minimally invasive decompression surgeries to restore space and relieve pressure: a microdiscectomy to trim the herniated disc and a partial laminectomy to remove some of the vertebra contributing to the crowding. “I immediately had a lot of confidence in him,” Gail says, describing Dr. Hardenbrook’s straightforward manner. “What he was saying made sense. I knew I had to do something, and it sounded reasonable and rational.”

As with other patients, Dr. Hardenbrook says he did not push Gail toward an operation, believing that non-surgical relief is the ideal outcome. But there comes a time, he says, when those approaches aren’t enough and surgery is the only way to regain the function needed to work and enjoy life.  “It’s a difficult step for a lot of patients,” he says. “They’re thinking, 'Maybe I’ll still get better.' But once you’ve reached that point, now you’re just in pain. You don’t get those years back.”

Thanks to Milford Regional’s recent partnership with Dr. Hardenbrook, Gail was able to have her surgery close to home, not only for the convenience, but also because she had been impressed with the quality and staff during previous visits. Her outpatient surgery, which took place in April, involved a small incision less than half an inch long. Dr. Hardenbrook used a special instrument and a thin stream of high-speed water to trim tissue and the herniated disc — a newer approach that minimizes trauma.

Some patients experience complete relief coming out of surgery, while others feel noticeably better but still need time to let compressed nerves fully rebound. Both groups must heal from the surgery itself, though recovery is shorter with minimally invasive approaches. Upon waking in the recovery room, Moser did not feel 100 percent better, but noticed significant improvement. She went for a short walk the next day and started working again a month later, never needing pain pills. During that time, she finally booked her tickets to Spain. “That’s how good I felt,” says Gail, who is still completing physical therapy. She now recommends Dr. Hardenbrook to anyone she meets with back problems.

“To me, it was well worth it,” she says.




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