Shirley Mueller typically would have been enjoying springtime at her home in the Berkshires just a few miles from Great Barrington, but she couldn’t. She was plagued by urinary and bowel issues as well as pain in both buttocks. A CT scan and visits to four different doctors didn’t provide any answers. Then she made an appointment with an orthopedic doctor who pinpointed the problem.
“She told me I was going to need an MRI right away and would likely need surgery,” says Mueller. “My spine was impinging on my nerves.” She spoke with an orthopedic surgeon in Boston who highly recommended Dr. Dennis Oh, chief of the Division of Neurosurgery at Baystate Health.
Mueller had lived in New York City for 35 years before moving to western Massachusetts and was considering returning there for surgery. But she was grateful she turned to Dr. Oh, who specializes in spine surgery, first. He set aside time that week to immediately meet with Mueller and plan a course of action.
“Shirley had spondylolisthesis, a misalignment of two vertebrae that can lead to stenosis and severe compression of the nerves,” says Dr. Oh. “While uncommon, spondylolisthesis can lead to cauda equina syndrome.” In Shirley’s case, it did.
What is Cauda Equina Syndrome?
Cauda equina syndrome is a rare and serious neurological condition where multiple nerve roots are severely compressed, leading to pain, leg weakness, bowel and urinary problems, and lack of feeling in the buttock and genital area. If not treated it can result in permanent loss of bowel and bladder control, and paralysis of the legs. Most often that treatment involves emergency surgery.
“Our philosophy at Baystate is that we try to avoid surgery, but when a patient does need it, we perform the most minimally invasive surgery possible,” says Dr. Oh.
“I didn’t know what to expect at my first visit with Dr. Oh,” Mueller recalls. “He quickly put me at ease with his explanation of my medical situation and the need for emergency spinal surgery to avoid further damage. He was thoughtful in giving me sufficient details and describing the surgery and his experience.”
That same week in early August after her initial appointment, Mueller came to Baystate Medical Center to have Transforaminal Lumbar Interbody Fusion (TLIF) to fuse the misaligned vertebrae of the spine using a bone graft.
Shorter Hospital Stays and Faster Recovery Times
In this specialized minimally invasive technique, Dr. Oh made a small incision in the back to access the vertebra and remove the degenerative disc.
He then placed an implant with bone graft to realign the vertebral bones and relieve pressure on the nerve roots.
There are many advantages of having a minimally invasive TLIF procedure over traditional spine surgery. The incision is smaller and there is less disruption to muscle tissue. The procedure is typically a same day surgery; the patient can go home the same day and most patients can return to normal activity within a few weeks. “With the traditional procedure, we had patients having to stay in the hospital for a week and be out of work for three to four months,” says Dr. Oh.
A Leading Hospital in the Nation for TLIF
Baystate Medical Center has been performing TLIF for over 10 years and is a leading center in the nation for this procedure. In 2021, Healthgrades named Baystate one of only two hospitals in Massachusetts as one of the Top 100 hospitals in the nation for spine surgery. Additionally, length of stay for patients at Baystate after the surgery is half the national average and the readmission rate is half the national average as well.
Once the surgery was complete Shirley immediately started on the road to recovery and to leading a more normal life. While the damage to her nerves was so great that they may not ever fully heal, her symptoms have greatly improved, and she has “learned to manage my condition with regular advice from my caring physicians,” Mueller says.
Many patients are fearful of the risks of spinal surgery and that their provider may unnecessarily recommend a procedure. “The message here is that you do not need to fear spinal surgery,” says Dr. Oh. “Most of the time, we are going to recommend you don’t have it. We only perform the surgery on two out of every 10 patients. But for the right patient, it can be highly successful. And you don’t have to travel out of the area to have the surgery performed.”
Learn more about the neurosurgery team at Baystate Health.