Back pain is a leading cause of disability in older adults, and studies show that a significant percentage of those with chronic severe back pain report mobility problems and work limitations.鈥
鈥淢ost people can trace their pain back to a specific moment,鈥 said Amy Still, APRN, a nurse practitioner at 91麻豆天美直播. 鈥淭he overwhelming majority will say, 鈥業 did this movement, and then it occurred.鈥欌
For Jim Foster, the moment came while working out in his home gym.
It was 2021, and Foster, a retired basketball coach who was 72 at the time, had just moved to Utah to be closer to his son and his son鈥檚 family. Not long after relocating with his wife, Donna, Jim hurt his back lifting weights.
鈥淪omething twisted the wrong way. After that, I had trouble carrying things, going up steps, and walking in general.鈥
It turned out that Foster had herniated a disc in the lumbar (lower back) region of his spine. For the most part, though, the pain was concentrated in both his hips. This is common with herniated discs, where a fragment of the disc breaks off and pinches a nerve. This causes excruciating pain that often spreads from the lower back into the hips and legs. While age-related wear 鈥揳nd tear, hereditary risk, and lifestyle choices can all contribute to disc herniation, most arise from movement-specific injuries like Foster鈥檚.
Foster called an acquaintance who had worked as an anesthesiologist in Utah. 鈥淪he gave me some names, and Dr. Mahan was at the top of the list,鈥 he said.
Mark Mahan, MD, FAANS, a spine and peripheral nerve surgeon at U of U Health. 鈥淩ight away, the level of comfort I felt with him was terrific,鈥 Foster said. 鈥淚 was just so impressed with everybody in his office. And whenever Donna had questions, Dr. Mahan didn鈥檛 hesitate to answer them, which made her feel very comfortable.鈥
Ultra-minimally invasive approach
Mahan, who鈥檚 also an associate professor of at the Spencer Fox Eccles School of Medicine at the University of Utah. offered to perform endoscopic surgery to fix Foster鈥檚 herniated disc and alleviate the painful nerve. The ultra-minimally invasive procedure involves removing the disc fragment through a tiny 7-millimeter incision鈥攁bout the width of a pen. Within minutes, Mahan was able to remove the herniated disc fragment, immediately relieving nerve compression and Foster鈥檚 pain. More importantly, by operating with a camera and specialized instruments, all of the spine musculature remained intact, minimizing risks and speeding recovery.
It was the first of five endoscopic surgeries Mahan would perform on Foster over the next three years.
鈥淲ith endoscopic surgery, all the work is done inside,鈥 said Still, who has worked closely with Mahan for more than a decade. 鈥淭his approach reduces risks of infection and muscle damage, shortens the duration of a patient鈥檚 hospital stay, and minimizes post-surgery pain and recovery time.鈥
Endoscopic surgery also eliminates the chance of post-laminectomy syndrome, a condition characterized by persistent pain, often in the back, neck, or extremities, after undergoing spinal surgery. 鈥淚n traditional spine surgery, the disc is taken out, but the patient is forever changed because of the surgical approach,鈥 Mahan said. 鈥淭hat鈥檚 the reason why I switched to doing surgeries endoscopically, because that鈥檚 the way I would want to take care of myself or my family.鈥
The challenge with endoscopic surgery is that it鈥檚 technically harder and requires more training and more specialized sets of tools. But for Mahan, the only surgeon at University of Utah Hospital who performs endoscopic surgeries and the only one in the region who performs the highly advanced surgeries that Foster needed, the additional training has been worth it.
鈥淚 was apprehensive going into surgery and getting knocked out, but then I woke up, and boom, it鈥檚 taken care of. The pain was gone,鈥 Foster said. 鈥淒r. Mahan and his staff just exude confidence in you as a patient. You just feel as though everything is going to be good. It鈥檚 a great feeling.鈥
Just the beginning
Not even a year later, Foster injured himself again, this time lifting a crate out of his car. 鈥淎ll of a sudden, my back popped in another spot,鈥 he said.
Recurrence of鈥痩ow鈥痓ack pain鈥痠s very common, with more than two-thirds of individuals having a recurrence within 12 months after recovery. This time, though, the pain was worse, and the injury more debilitating.
鈥淚t was miserable,鈥 Foster said. 鈥淚 couldn鈥檛 stand straight. Walking was difficult, even with a cane, as I鈥檇 have to bend over 90 degrees. I remember lying in bed in the morning, psyching myself up to swing my legs out of bed and try to stand.鈥
Mahan performed another minimally invasive surgery, fusing two vertebrae in his neck.
鈥淚 knew Dr. Mahan would be able to help. I had complete trust in him and his team to take care of this new injury.鈥
Again, the results were immediate鈥攏o pain and minimal recovery time.
鈥淩ecovery was easy because the source of the pain was removed,鈥 Foster said. 鈥淪o, then it was about physical therapy to strengthen muscles in the area that hadn鈥檛 felt right because of what had been going on.鈥
An endoscopic surgery to correct cervical nerve root compression followed, as did an endoscopic surgery to address carpal tunnel syndrome, a peripheral nerve disorder in which a nerve outside of the spine becomes pinched or compressed. Mahan is one of the few surgeons in the Mountain West region who operates on both spinal cord and peripheral nerves.
鈥淛im benefited from our ability to seamlessly handle all of these issues,鈥 Still said. 鈥淰ery few spine surgeons will also do a peripheral nerve surgery like carpal tunnel. But it can be very helpful for continuity of care and having a full picture of how injuries may be interrelated that you wouldn鈥檛 get by referring a patient out to another surgeon.鈥
Pain-free
More than a year out since his last surgery, Foster continues to be pain-free. His walking, arm mobility, and hand strength have all improved significantly.
鈥淭here鈥檚 a big difference between pain and pain-free,鈥 Foster said. 鈥淭here鈥檚 also a big difference when you can stand up on your own without assistance, without a cane or a walker, and you can actually do it the way you鈥檝e always done it. I鈥檓 not going to run any marathons, but I鈥檓 incredibly thankful every day I can get in and out of bed, I can get out of the chair, I can turn and see one way or the other. I mean, it鈥檚 night and day.鈥
