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Back in the Swim of Things

Posted on August 17, 2017 in Back Surgery

Knoxville hairstylist takes plunge for back relief.

For Angela Maxwell, back pain is but a bad memory.

Almost a year after Joel Norman, MD, a board-certified neurosurgeon at Fort Sanders Regional Medical Center, took all her pain away, the 67-year-old Knoxville hairstylist is literally back in the swim of things.

“I try to swim daily except for Mondays,” said Maxwell, who does laps and exercises in the pool.

She had endured back pain for years and had exhausted other treatment options, including steroid injections, chiropractic treatment and even massage therapy.

“I went to a spinal surgeon about seven years ago who told me I probably needed to have surgery, but he said, ‘Wait until you can’t stand it any longer,’” said Maxwell, who realized last year she had passed that point. Her lower back pain radiated down both legs, causing frequent falls and difficulty with daily living tasks like getting in and out of the bed or shower.

So when one of her customers told her about a friend who had great results with surgery by Dr. Norman, she wasted no more time. “I called immediately, got a new MRI, and I got in to see him in a week. After he saw my MRI, he said, ‘This isn’t an easy fix. You’ve got a lot going on down there.’”

Dr. Norman explained that Maxwell had spondylolisthesis, or instability of the third and fourth lumbar vertebrae in the lower back. “This instability is thought to be a cause for lower back pain,” he said. “In addition, she had stenosis, or narrowing, of the canal and foramina [the passageways between vertebrae] that the nerves pass through in the spine. 

The “fix” Dr. Norman used was a minimally invasive procedure called Transforaminal Lumbar Interbody Fusion. TLIF is a spinal fusion technique commonly used in treating spondylolisthesis, degenerative disc disease or recurrent disc herniations.

During her surgery, Dr. Norman made three small incisions around Maxwell’s lower back, and then inserted screws into the L3 and L4 bones on both sides.  He completely removed the joint of the spine at the site of the compression, allowing for direct visualization and decompression of the nerves that pass through this level.  Once the nerves were decompressed, the disc between the bones was completely removed and a “cage,” or spacer, was inserted into the disc space and packed with bone and materials to encourage bone growth between the vertebrae. A rod was then inserted into the screws on each side of the spine to hold everything in place. 

TLIF offers several advantages over the traditional or “open” surgical method, which requires a large midline incision, stripping muscle tissue away from bone and placement of large retractors. Among those benefits are shorter hospital stays, less blood loss, less soft tissue and muscle damage, faster healing time and less pain.

Dr. Norman said Maxwell has “done great” since the surgery. “She’s had no symptoms related to her back and no nerve pain.” 

 “When I went back to Dr. Norman after the surgery I was feeling totally awesome,” said Maxwell, who says she now enjoys swimming 20 minutes a day, working in her yard and long walks – up to five miles when the weather is nice.

“I asked him if I could give him a hug, and I said, ‘You have really helped me. You have changed my life.’ I don’t know what I would’ve done without him.”

That’s not an unusual occurrence around Dr. Norman’s office. “Some people have suffered for several years with the pain before seeing me, and the relief of their pain can be life changing,” he said.

Maxwell is so happy she says she’s now telling everyone. “I could holler from the rooftops about Dr. Norman, his staff and the people at Fort Sanders Regional,” she said. “They were all great. I wish I’d been going to Fort Sanders all along. If you have back problems, go see Dr. Norman.”