Minimally Invasive Spine Surgery Gets Consuela Back on Her Feet

Consuela Stephens is always on the go. The 74-year-old keeps busy gardening, cooking, and caring for her twin sister, who is ill. When Consuela had to have knee surgery, she expected that she’d be back to her active life in a few weeks. But while recovering, she began to have painful back spasms, which eventually became completely debilitating.

For the next three-and-a-half years, Consuela endured rounds of trigger point injections, epidural blocks, opioid medications and radiofrequency ablation procedures. She even had a spinal cord stimulator implanted in her spine to try to interrupt the pain signals. None of this relieved her pain, which was so severe that she had to sleep sitting in a chair. And it was only getting worse.

“When I initially got my spinal cord stimulator, its level was set at 16. By the time I consulted with Dr. Hamilton, I was back to taking opioids for pain, back to having epidural injections, and my stimulator was turned all the way up to 55. I couldn’t get any relief, and I had had enough.”

A computer search brought her to the Inova Spine Program, where she took an online back pain assessment. “I got an email back within minutes and was connected with Dr. Hamilton’s team,” Consuela said. In April 2021, Consuela met with spine nurse practitioner Jessica Patel, NP, who got her started with physical therapy while arranging for advanced imaging. “The quality of Consuela’s life had decreased significantly because of her back pain. She is an avid gardener, and the fact that she couldn’t do much in the garden was a big indicator,” Patel said.

The CT scan of Consuela’s lower back showed spondylolisthesis, a painful condition in which one of the spine’s vertebra slips out of place and rests on the adjacent vertebra, compressing the nerve roots. She met with neurosurgeon John Hamilton, MD, PhD, Medical Director of the Inova Peripheral Nerve Program, Inova Health System; Medical Director of the Inova Spine Program at Inova Fairfax Hospital; and Section Chief, Neurosurgery at Inova Fairfax Hospital, to talk about a surgical solution. “Consuela had severe mechanical pain, which nonoperative methods had not succeeded in relieving,” Dr. Hamilton said. “Her daily activities were impinged upon to the point where she couldn’t do anything that she loved. Even something like loading the dishwasher would set off pain of 8 to 10 on a 10-point scale.”

Although Consuela was a bit nervous about spine surgery, her discussions with Dr. Hamilton made her feel confident that surgery was the right choice. “Dr. Hamilton showed me my X-rays and MRI and explained to me where the problem was, to the point where I understood fully, although he always left the door open for any additional questions,” Consuela said. “He assured me that the surgery would help to relieve my pain.” She underwent surgery in August 2021.

Dr. Hamilton used a minimally invasive approach to correct Consuela’s spondylolisthesis. Minimally invasive spine surgery causes less damage to the back muscles, resulting in a faster recovery for the patient and less pain after surgery. “First, I went in from the side to perform a direct lateral interbody fusion. Then, I used posterior approach for nonsegmental fixation and decompression from the back. Both techniques are minimally invasive. After surgery, she experienced significant relief. Her pain level went down to a 1 or 2, instead of 8 to 10.”

Consuela’s hospital experience had all the hallmarks of caring and excellence that she has come to expect from Inova. “The surgery began on time, and afterward, the nurses were very conscientious and caring. I had visits every day from the team, including Dr. Hamilton, several other physicians, physical therapists and occupational therapists,” she said. “They made me as comfortable as they possibly could. Whenever I come to Inova, and I go there quite a bit, I always feel like my wellness is their priority.”

Today, Consuela is enjoying her fall garden as she prepares for winter, pruning flowers and decorating with pumpkins. She’s back to getting on her hands and knees in the garden and standing at the stove for an hour – all without pain.

“I have not had an iota of pain in my back since my surgery. After three-and-a-half years of pain, I’m just about back to my normal life,” Consuela said. “I am so grateful to Dr. Hamilton and the entire team. There are no words.”

To learn more about Inova’s Spine Program at Inova Neurosciences, visit inovaspine.org.