Not long ago, when he preferred to focus on his golf score, the numbers Don Ferris thought about most often were on a pain scale from zero to ten.
He usually hovered between an awkward six and a much more punished seven.
The retiree from Kentwood, Michigan, can barely remember when back pain first started creeping in in his life.
“It started when I was 20,” he said. “With a pinched nerve.”
Like many who suffer from back pain, he decided to live with it. As a builder, he did his best to protect his back from further injury, often with a protective belt.
During more acute flare-ups, he occasionally sought help from chiropractors. He even consulted with doctors.
“They said there was nothing they could do,” said Ferris, 86.
With ice, heat and clenched teeth, he would find ways to get through the crisis. Ultimately, however, he decided to seek care from the Spectrum Health Spine and Pain Management Program.
There he started getting cortisone injections. They helped, but only a little.
“I might feel better for two weeks, but it would wear off,” Ferris said. “And I should suffer in the next few months until the next injection.”
Ferris’ health care provider suggested contacting Yi Jia Chu, MD, a physician specializing in interventional spine and chronic pain management at Spectrum Health.
dr. Chu told Ferris about the Vertiflex procedure, a minimally invasive treatment for lumbar spinal stenosis.
It involves inserting a spacer — about the size of a golf tee — through a small incision in the back. For Ferris, it would spread between his problem vertebrae, eliminating much of the pressure on his spinal nerves.
It could provide the relief he needed.
Ferris agreed to give it a try.
dr. Chu performed the procedure in December at the Spectrum Health Hospitals Surgery Center, on Lake Drive in Grand Rapids.
For the first time in decades, Ferris was able to move without pain.
“Almost right away,” he said. “My pain went from a six to one.”
Patient Specific Solutions
The Vertiflex procedure treats a certain type of pain: mild to moderate lumbar spinal stenosis.
The spinal nerves run through a column made by all 33 spinal vertebrae. Ideally, said Dr. Chu: the nerves must be able to move freely within this protected space.
But age, degeneration and injury can shrink that space, putting pressure on nerves. This causes spinal stenosis.
The condition sometimes manifests itself in uncomplicated back pain, but often it is more complex.
“These patients may be able to sit just fine, without pain,” said Dr. Chu. “But if they get up or walk for a while, it becomes very difficult.”
Many patients describe it as walking through quicksand or an extremely heavy feeling in their legs.
“They often lean over things, such as a shopping cart, because a bent or leaning forward position slightly opens up their spinal canal.”
But as soon as they stand up straight, their backs cling to the nerves. The blood is not flowing properly and they begin to experience a symptom called neurogenic claudication.
“They can’t walk or stand for an extended period of time and get immediate relief when they sit down,” said Dr. Chu.
Other surgical procedures treat lumbar stenosis. These include laminectomy, the most common surgical approach, in which doctors remove the ligaments, bones, or spurs that put pressure on the nerves.
Spinal fusion is another option, which reduces movement in the spine through hardware, such as rods and screws.
Those procedures are sometimes done together.
“It’s not that one approach is better than the other,” said Dr. Chu. “It is very patient-specific. But those surgical procedures are considerably more invasive, which means that recovery can take considerably longer.”
Vertiflex, on the other hand, is minimally invasive.
After inserting the device through a thin tube, “we hold it between the two vertebrae, with the teeth touching,” said Dr. Chu. “Then we deploy it by unscrewing it. It prevents the spine from coming into a fully extended position, keeping the spinal canal as wide as possible.”
The 10-minute procedure — you can watch a video animation from the manufacturer — doesn’t even require general anesthesia.
“Patients can go home the same day,” said Dr. Chu.
The relief is often immediate – and astonishing.
“If we successfully block the extension and are the right size, you shouldn’t have to close the spinal canal when you stand up,” said Dr. Chu.
An end to endless pain
While Dr. Chu said he was delighted Ferris saw such good results, pointing out that the pain relief came after decades of suffering.
While most people will develop back pain or injury during their lifetime, an estimated 13% of the U.S. population struggles with chronic back pain, pain that lasts for 12 weeks or more.
Spinal stenosis is especially common in older adults.
Still, most people with chronic pain wait up to nine years before seeking treatment. And they often spend years researching one type of treatment, physical therapy or chronic pain management, before turning to surgery.
“We are often seen as the last resort,” said Dr. Chu.
He and his team are working to change that paradigm.
“If people can benefit from minimally invasive treatment sooner, we want to help,” he said.
With an aging population, new approaches will become increasingly important. That’s because aging is inherently bad for the back.
“Unfortunately, that’s exactly how it will be,” said Dr. Chu. He estimates that up to 80% of his patients seek relief from age-related degeneration.
“But we’re learning a lot more about prevention,” he said.
This may include physical therapy, improving core strength, and doing weight-bearing exercises that help slow the decline.
Ferris is definitely moving more. He’s happy to have his freedom back – and these days he’s more focused on his golf score than numbers on the pain scale.
He recently had heart surgery for an unrelated condition, but he’s taking that to heart as he works his way back to full activity and a goal of 25 minutes of exercise a day.
He spends a lot of time working on model cars and trucks in his man cave. He and his 62-year-old wife, Joyce, spend a lot of time with their many grandchildren.
“I’m doing everything now,” Ferris said. “I can move very well. And it feels great.”