Catherine Whitney loves to be active. She enjoys playing pickleball and golf, traveling, spending time at the beach and boating with her family. In addition, she works in kitchen and bath design, which requires her to be on construction sites and take measurements for renovations.
At age 61, Catherine has no plans of slowing down or retiring. Following in her parents’ footsteps, maintaining her health has always been a priority. That’s why her struggle with back, hip and leg pain has been especially challenging.
Catherine finally found relief from chronic pain when she consulted SpineFirst, a partnership established by Atrium Health and Carolina NeuroSurgery & Spine Associates (CNSA) in 2021. Her story illustrates how patients can benefit from minimally invasive spine surgery in an outpatient setting.
Persistent back pain
Four years ago, Catherine developed persistent dull pain in her lower back. Her doctor suggested physical therapy but didn’t recommend further diagnostics or treatment.
Two years later, she traveled to the beach with her family. At one point, she stood up and felt something pop in her lower back. This incident caused her pain for two weeks. While that pain eventually went away, weeks later, she started having pain in her left leg and hip. She also had some pain in her right leg.
Over the past year, Catherine’s pain became more and more persistent and uncomfortable. The constant, dull pain made it difficult for her to work and participate in sports. She also struggled to go shopping or engage in other activities.
“There was never a time it didn’t hurt,” Catherine explains. “Even doing nothing was painful. So I held back a lot personally and in my business, which negatively affected my life.”
Catherine had an MRI and X-rays taken to assess her condition. She had some cortisone shots in her back and hip, but they didn’t bring her any lasting relief. She also did some physical therapy to try to prevent surgery. After months of frustration, her friend recommended she consult a neurosurgeon about her condition.
Accurate diagnosis and treatment plan
As a resident of Charlotte, Catherine was familiar with SpineFirst. Its spine surgeons had an excellent reputation throughout the community, making her decision easy. Catherine consulted Dr. Tim Adamson, a neurosurgeon specializing in minimally invasive spine surgery, right away.
After discussing her case and consulting her imaging results, Adamson diagnosed Catherine with lumbar spondylolisthesis, which occurs when a vertebra in the spine slips forward and over the vertebra below it. In her case, her 4th vertebra (L4) slid forward over her 5th vertebra (L5). Her body tried to stabilize her L4 by thickening the ligaments and tissues that hold the vertebra in place. This thickening caused her nerves to compress, which caused nerve pain in Catherine's back, leg and hip.
Adamson scheduled Catherine for a minimally invasive, outpatient spine surgery at Carolina Center For Specialty Surgery (CCSS) just a few weeks later. CCSS is a joint venture ambulatory surgery center between Atrium Health and Carolina NeuroSurgery & Spine Associates and a foundational facility of their SpineFirst partnership.
“I wasn’t scared at all,” explains Catherine. “Based on my research, the spine fusion procedure had a high success rate. And Dr. Adamson was completely confident about my case.”
While Catherine felt secure about the procedure, she received some negative feedback from friends and family. “Just the thought of a spine fusion or spine surgery seems to make some people feel uneasy,” she notes. “But what they don’t realize is that the right doctors and the right technique can make all the difference for someone who suffered as long as I did.”
Two-part spine procedure
Catherine’s spine procedure involved two steps: decompression and fusion. First, Adamson performed a decompression to remove the overgrown tissue (and associated pressure) from the nerve. Second, Adamson used a transforaminal lumbar interbody fusion (TLIF) to put her L4 and L5 back in alignment and fuse the vertebrae. The fusion allows the vertebrae to grow together and stabilizes the spine.
The minimally invasive procedure is performed under general anesthesia and takes 90-120 minutes to complete. Adamson and his surgical team use ultrasound-guided muscle blocks to put the muscles to sleep around the surgical site to help control pain. The numbing medications last for three days, allowing the patient to go home the same day of surgery and rest comfortably.
Leadership in outpatient spine surgery
For the past decade, CCSS has been a national leader in outpatient and minimally invasive spine surgeries. According to Adamson, the center is among only a few centers in the country that are performing lumbar fusions as an outpatient procedure. The surgeons have performed more than 200 of these outpatient procedures over the past eight years. Overall, CCSS has completed over 20,000 spine surgeries since 2007.
“When a center does a procedure routinely, it allows the whole care team – not just the surgeon – to become experts in caring for the patient and delivering the best outcome,” explains Adamson. “This is especially important for patients having outpatient spine surgery.”
According to Ryan Myers, director of surgical services at CCSS, the center consistently reports patient satisfaction scores of more than 98%.
“Patients appreciate how we offer a clean, quiet and cozy environment. Plus, they benefit from our collaborative teamwork, which enables us to deliver efficient, professional care,” explains Myers. “We treat each patient like they are one of our own loved ones, going the extra mile for them at all times.”
Recovery and physical therapy
Catherine went home the same day – just four hours after surgery. She was able to walk up the stairs of her home that night. She spent the next eight weeks resting, mostly in bed. She would go for walks to help her spine muscles heal. During this time, she was not allowed to bend or twist. For the first month, she was not permitted to lift more than 10 pounds.
“Following a spine fusion, it takes six months to grow the bone and make it solid,” Adamson explains. “The first month of recovery allows the muscle soreness to subside and the incision to heal. We want patients to walk a mile or two each day. As they become more comfortable, we get them started on physical therapy or exercise to begin rebuilding the spine muscles.”
The pain Catherine experienced during her recovery was “very manageable.” She went off her pain medication two weeks after surgery and switched to an over-the-counter pain medicine. Catherine completed 10 physical therapy sessions and was able to continue doing the exercises at home.
Approved for unlimited activity
Adamson recently saw Catherine for a follow-up appointment. Since her X-ray looked excellent, he approved her return to unlimited activity.
“I’m doing great,” notes Catherine. “Thankfully, I have the rest of my health intact. So I don’t hesitate to do anything, including climbing a ladder, playing sports or doing yardwork. I’m not worried like I was before.”
Catherine returned to playing pickleball in September. She doesn’t have any ongoing pain or discomfort. If she overdoes an activity, she rests her muscles for a day and then is back to normal.
According to Adamson, a big part of the success of outpatient spine surgery is the doctor identifying the ideal candidates. Catherine was impressed by how Adamson knew exactly what she needed to feel better.
“Catherine just had that one spot that was abnormal and causing problems, so it’s easier when you can focus on one area,” says Adamson. “She’s a very motivated patient, which made my job easier. Catherine is part of the routine outcome we expect to see with patients in an outpatient setting. She’s a great example of what we can accomplish.”
Learn more about SpineFirst and get access to the best possible spine care by the region’s largest team of spine specialists, with over 80 years of experience. To learn more about SpineFirst, visit SpineFirst.com. To make an appointment with a SpineFirst provider, call 704-831-4000. To request a second opinion for spine surgery, visit SpineFirst.com/second-opinion.
