A neurosurgeon at NCH was recently able to relieve a man of the sciatica pain he suffered in his back for 50 years.
Back pain is one of the most common reasons people visit a doctor. With older people, it’s often brought on by a condition called spinal stenosis, which is a narrowing of the spinal canal.
This carries severe pain if a nerve is compressed. The ultimate solution is surgery, but even that can fail over time.
“I’ve never been able to do this before,” said John Koffel, who has a procedure done on his back to deal with pain recently.
To see Koffel tee it up is almost miraculous.
His back pain started with an accident in his teens. Despite several surgeries, it only got worse.
“I dealt with sciatica pain for 50 years. And I lived with that. But then it turned to nerve pain and it got really excruciating, worse to the point where I was debilitated,” Koffel said. “I had to walk with a walker. I was afraid I was going to be confined to a wheelchair the rest of my life.”
His options were few and his pain was enormous.
But when NCH neurosurgeon Edison Valle took images of his spine, he saw an opportunity.
“On the other side you don’t even see the nerve,” Valle said. “From all the surgeries that he’s had, he’s had a lot of scars on one of his nerves. The nerve that was going on to the right leg was severely compressed to the point that he was in between two bones that every time they move the nerve was basically crushed.”
Past surgeries to fuse his spine and relieve pain were now choking a nerve.
The fix was to open a space to free it. That required a level of precision made possible by combining several cutting-edge techniques.
The first was to use the Arthrex NanoScope™ visualization system, mostly used in sports medicine surgeries. It’s a single-use camera system with chip-on-tip technology, designed to be minimally invasive. In this case, it was used to navigate into a small space.
“It looks like a needle, basically. And it gives you great images,” Valle said.
The challenge now was to get through layers of scar tissue and remove bone without damaging the nerve.
“The next tool that allow us to do this was basically an ultrasonic aspirator. Which is basically a tool that is also minimally invasive,” Valle said. “Through ultrasonic waves that give and take into the bone you can basically destroy the bones and at the same time aspirate the bone that is pushing onto the nerve Without getting into the nerve itself, and being able to create a new house for the nerve.”
For all its complexity, this ultra-minimally invasive surgery was over in an hour. The results were immediate.
“This was the first surgery for the system where you use all these tools that are technology-driven and that are in innovation, right, to be able to help somebody like him,” Valle said.
Koffel said for the first time in 50 years, he has no back pain.
“I’ve never lived without back pain. And it’s the first time I don’t have it. I really don’t know how to handle it, to be honest with you,” Koffel said.
He now feels free to enjoy life.