Shane Rosenthal couldn’t take it anymore. He was desperate for relief from his chronic back pain. He had recurrent disk herniation in his spine. The “horrible” sciatica pain in his left leg kept him from sleeping more than two to three hours at a time. The intense spinal pain and pressure made it difficult for him to move.
Shane’s life dramatically improved when he consulted SpineFirst, a joint venture established by Atrium Health and Carolina NeuroSurgery & Spine Associates (CNSA). His story highlights the value of second opinions and a life-changing outcome from outpatient spine fusion surgery.
History of pain and treatments
Shane’s pain started seven years ago when 100-hour work weeks as a software developer took a serious toll on his spine.
“I remember standing up one day from my desk and feeling so much pain in my back,” says Shane.
Shane tried numerous strategies to manage his pain. In 2016, he had a lumbar discectomy (a surgery that repairs a disk in the lower back), which successfully treated his sciatica pain. Unfortunately, he developed recurrent disk herniation. Despite optimal conservative therapy, which included steroid injections and physical therapy, Shane needed additional surgery.
Shane’s primary care doctor referred him to a local surgeon for imaging and a consultation for his pain. At his initial appointment, Shane was recommended an anterior lumbar interbody fusion (ALIF), a spine procedure that fuses two vertebrae in the lower back.
Shane had concerns about having surgery at the first spine surgery practice. He said they weren’t diligent about answering questions about the procedure and didn’t offer much help with pain management. After looking at his latest MRI results, a radiologist recommended he consult a neurosurgeon about his spine fusion.
A huge weight lifted
Shane was anxious to get a second opinion so he could schedule his surgery as soon as possible. Through an internet search, he discovered SpineFirst. Within an hour of filling out the form, the clinic contacted Shane and scheduled his consultation with physiatrist Dr. David Wiercisiewski one week later. Wiercisiewski helped Shane schedule an appointment with Dr. Mark Smith, a neurosurgeon with CNSA and vice chief of operations for SpineFirst, as quickly as possible.
“The week between those appointments was marked by horrible pain, but it felt like a huge weight was lifted off my shoulders,” Shane explains. “I knew I would get the help I needed.”
When Shane met Smith, he immediately felt at ease. Smith recommended a transforaminal lumbar interbody fusion (TLIF), a minimally invasive, outpatient surgery designed to stabilize the spine.
“I knew the surgery he recommended would be good for me,” Shane says. “During his residency, Dr. Smith trained with the surgeon who created the TLIF procedure. I felt like I was in good hands. I was excited about an outpatient procedure since I healed well from my previous outpatient back surgeries.”
Smith was able to schedule the TLIF surgery eight days earlier than the surgery that was planned at the first surgical practice. Shane’s primary care doctor helped him manage his pain with steroid injections and medication up until a week before surgery. To ensure the pain medication would work during his procedure, he had to work through the last week without any medication.
“I was counting down the days until my surgery,” Shane says. “That last week was brutally painful. I was constantly crying and unable to do anything. It was hard for my son to see me that way.”
Minimally invasive surgery
Shane’s procedure took place at Carolina Center For Specialty Surgery (CCSS), a joint venture ambulatory surgery center established between Atrium Health and CNSA and a foundational facility of their SpineFirst partnership.
Shane remembers CCSS being peaceful the morning he arrived. He only waited 10 minutes before being taken back to prepare for surgery. He recalls having a lot of pain in his back that day. To minimize Shane’s discomfort, the anesthesiologist waited to give him a lumbar block until he was under anesthesia. (This injection helps reduce postoperative pain.)
Using the TLIF procedure, Smith removed Shane’s abnormal disk that kept herniating and fused his spine. The procedure only requires small incisions. Treating the problematic disk prevents future herniation and subsequent compression and pain in the nerve.
Immediate relief
As soon as Shane woke up from surgery, his sciatica pain was gone. He only had some discomfort from the procedure. About 90 minutes after surgery, he was able to stand up and sit in a chair.
“I felt great,” Shane explains. “I got up and shuffled to the bathroom. I walked up and down the hallway without a walker. My wife walked next to me, but I was completely self-sufficient. Each step got a little bit better. I walked around for about an hour and a half.”
Shortly thereafter, he was released to return home.
Life-changing recovery
Shane spent the first few weeks of his recovery resting at home. He bought a recliner, which made sleeping more comfortable. For the first month, he wasn’t allowed to lift anything heavier than a jug of milk.
Before surgery, Shane had to use his arms to help him sit up or stand. Only six days after surgery, Shane could sit up using his abdominal muscles.
Shane notes, “It’s been a life-changer to learn how to move correctly and to feel the proper support and stability of my spine again.”
Three weeks after surgery, Shane traveled to Colorado and carried his backpack through the airport without any issues. He had no back pain during his trip.
Four weeks after surgery, Shane started physical therapy with Megan Simpson of CNSA, who has a doctorate in physical therapy and is a member of the SpineFirst team.
“Megan carefully studied the way I moved and identified my key problems,” Shane explains. “Her help during my recovery has been revolutionary. I probably could have avoided surgery if I had met her five years ago.”
Simpson has been helping Shane build up the muscles in his left leg and his left glute (buttocks muscle). She also gave Shane recommendations for proper running shoes that provide shock absorption for his spine. The shoes have improved his blood flow and muscle performance when walking.
Outstanding staff and facility
“Every interaction I had with the SpineFirst team made me feel like I was important,” Shane says. “They are like angels on earth. I wasn’t just a number on a list. I mattered to them.”
Shane was amazed by the dedication of every staff member at SpineFirst.
“Everyone loves their job and is passionate about helping patients,” Shane continues. “They weren’t just tolerating their job but doing their best. They are so eager and ready to help.”
Shane was also impressed by the cleanliness and organization of the CCSS facility. His room included a pleasant view, which added to his comfort. He also appreciated how smoothly the day went. From the time he arrived to the time of discharge, he rarely waited more than 10 minutes.
Shane’s wife was given a private room, which included a private bathroom, to use during her husband’s surgery.
“She could just relax in a recliner,” Shane says. “I can’t overemphasize how important that was in reducing her stress as well as mine.”
Ryan Myers, director of surgical services at CCSS, often hears positive feedback from patients about their quiet and cozy environment. Patients also benefit from the center’s collaborative teamwork, which enables them to deliver professional, efficient care.
Myers explains, “We treat each patient like they’re a family member and go the extra mile for them at all times.”
Importance of second opinions
According to Smith, when patients are being evaluated for a spinal operation, all available treatment options must be considered before making a final recommendation. The patient should be helped to fully understand the risks and benefits of each approach, allowing them to participate in their care.
“Most patients have a sense for how they’re being taken care of,” notes Smith. “Trusting your physician and having a good relationship with them are important pieces of the care paradigm. If there’s a lack of connection or perceived inadequacy in the care pathway, a second opinion can be comforting to the patient.”
To instill confidence in Shane, Smith explained the risks and benefits of the ALIF and TLIF procedures, both of which are considered viable options for lumbar fusion. Shane appreciated being able to discuss his surgery options with Smith based on his understanding of the potential risks and benefits of each.
Shane trusted Smith implicitly.
“His demeanor and responses to my questions convinced me that I made the right choice,” Shane notes. “In many ways, Dr. Smith saved my life.”
“Your surgeon is the one who truly makes a difference,” Shane continues. “Get a second opinion if you have any concerns. If you don’t feel 100% confident about your surgeon – like they only exist because of you – you should find someone else.”
Passion and positivity
Shane has been pain free since the day of his surgery. After six weeks, he could walk five miles on the treadmill. He’s now sleeping six to eight hours each night. Shane goes to the gym daily for cardiovascular training, stretching and weightlifting.
Shane regularly posts to a social media support group organized to help people dealing with serious back pain and spine issues. He created videos to document his recovery from spine fusion surgery.
Shane explains, “I want to help other patients in a similar situation see there’s light at the end of the tunnel. Chronic back pain doesn’t have to keep you from doing the things you love. I’m living proof that your life can improve.”
Now that Shane feels better, he plans to continue logging hours flying as a private pilot. His goal is to achieve his commercial aviation rating and his flight instructor rating within the next four years. He hopes to become a captain for a major U.S. airline.
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.
