In this issue

February 2018

Baby Boomer Bass Guitarist Keeps on Rockin’ after Minimally Invasive Spine Surgery

When Vincent Ruiz, 72, isn’t walking three miles around Lake Chabot with his wife Herma he’s rocking out on his bass guitar, playing songs with his band to entertain seniors at residential facilities around the East Bay. Or, he’s swinging a golf club at Monarch Bay in San Leandro.

Vincent and Herma have lived in Castro Valley for 45 years. He spent 30 years in the Navy as chief petty officer before landing a job as a radiologic technologist in Walnut Creek.

Vincent grew up with a passion for sports, playing tennis in high school and baseball in college. When he retired six years ago Vincent carried on his love of sports, playing tennis most mornings, then golf. Walking and running have kept him physically fit, and playing with the Melody Minstrels allows him to give something back to the community he loves.

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Fifteen years ago the pain started – first in his back then in his left leg. Activities like golf and even simple walking became increasingly difficult.

Vincent tried everything to ease the pain – stretching before golf, massage, acupuncture, physical therapy, chiropractic treatments, and anti-inflammatories. The pain only intensified. But he refused to give up the game.

“I was really in pain – every time I sat down I’d have to get up and stretch my leg. I had pain from my hip, and down my left leg to my toes,” Vincent recalls. “The pain was getting to be too much. Every morning I got up and I was stiff. Nothing worked.

“But I was afraid to have surgery. It was a last resort because I knew that Steve Kerr, basketball coach for the Warriors, had back surgery that left him in a lot of pain. That was part of the reason I put it off. Kerr said surgery is no guarantee.”

Vincent’s pain took a toll on Herma as well.

“Last year was the worst,” Herma said. “Vincent couldn’t hide the pain anymore. We went to Europe while he was in pain. Three days after we returned he had the surgery.”

Herma had recently retired from Eden Medical Center where she had worked as an ICU nurse alongside Dr. Randall of Pacific Brain & Spine. She had seen Dr. Randall’s interactions with patients up close and other friends do well following surgery. She insisted her husband see Dr. Randall.

Vincent finally took the step of having an MRI scan, which revealed lumbar spinal stenosis, a common degenerative condition, affecting the L5 and S1 nerves on his left side. He made an appointment with Dr. Randall.

Dr. Randall

“When I met with Dr. Randall he didn’t push the surgery. He even suggested physical therapy first and told me if it worked he wouldn’t need to see me again. But when he explained the procedure he gave me a lot of confidence. I opted to have the surgery.”

Vincent had a minimally invasive procedure called a lumbar laminotomy – a spinal decompression surgery in which part of the thickened bone and ligament is removed from the vertebra to relieve pressure where the nerve is being pinched.

Two hours after going into the operating room, Vincent was walking, and he was discharged that afternoon. As soon as he arrived home he took a stroll around his cul de sac. After six weeks he stopped taking any medication, there was no more pressure on his legs and he was free of pain.

“My life is 100 percent better. I’m not feeling the excruciating pain anymore, although I have some numbness in my thigh occasionally. I told Dr. Randall it was a miracle. I can walk and play golf. Dr. Randall is a true professional who cares about the patient. He is the best.”

For more information or to refer a patient to one of the neurosurgeons at Pacific Brain & Spine call (925) 884-2360.

New Spine Surgery Techniques Bring Faster Return to Daily Activity

Surgical options for symptomatic lumbar stenosis have continued to evolve and improve. The typical patient presents with symptoms of neurogenic claudication – pain or fatigue in the back, buttocks, and/or legs that worsens with standing or walking, and is relieved by sitting or maintaining a flexed posture. Lumbar stenosis is confirmed with an MRI. The most common indication for surgery is persistent symptoms that result in decrease in activity and quality of life. The neurologic exam is most often normal. EMG studies, if performed are often normal as well.

Years ago, surgery would have involved laminectomies – a bilateral exposure to remove the spinous processes and lamina at multiple levels. Because of the degree of bone removal and concern for instability, fusion was often included. Overall, this meant longer hospitalizations, prolonged recoveries, and potentially higher risk. 

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Now, areas of stenosis can be addressed in a more precise manner using minimally invasive microsurgical techniques, by performing multiple unilateral laminotomies that allow bilateral decompression without retracting the paraspinous musculature on both sides. The exiting nerve roots and thecal sac are directly visible under the operating microscope – ensuring both optimal nerve root decompression and safety.

The result of this approach is a thorough decompression with more preservation of normal boney architecture. Fusion is less often needed, even in the setting of spondylolisthesis. Most patients, even with multi-level surgeries, can be safely discharged home on the day of surgery or the next morning.

Many patients with radiographic findings of lumbar stenosis don’t have debilitating symptoms and are appropriately treated without surgery. But for those who find their activities limited, new surgical approaches can offer a high likelihood of improvement and more rapid return to normal activities to patients of all ages.