When Huntington Beach resident George and his wife, Cynthia, traveled to Europe, their trip turned out to be anything but carefree. George experienced such excruciating lower back pain that he could barely walk, much less enjoy the sights. Hoping to find some relief, he went to an orthopedist in Bavaria who gave him steroidal injections to get through the trip. “The flight home was okay,” says George, 71, who worked in business development for multinational corporations before retiring. “But I had to be escorted off the plane in a wheelchair.”
By the time he made it into the office of orthopedic spine surgeon Ram Mudiyam, M.D., George’s life had slowed to a crawl—literally. “I was bent into an ‘L’ shape and the pain was the most intense I’ve ever experienced,” he says. Dr. Mudiyam, who had performed hip replacement surgery on George two years earlier, diagnosed the problem as degeneration of the lumbar discs, which are gel-like structures that act as shock absorbers between the vertebrae. “When the discs deteriorate due to injury or age, they can press against nerve roots or the spinal cord, causing extreme pain,” says Dr. Mudiyam. Two of the discs in George’s lower back were seriously degraded—a fact that was confirmed by CT and MRI scans, as well as a specialized X-ray called a myelogram.
To alleviate George’s symptoms, Dr. Mudiyam ordered steroidal injections that act on the nerve centers around the vertebrae. Although the injections allowed George to be pain free for six months, subsequent treatments were less effective.
Following, he was virtually unable to move due to his lower back pain. Having had a positive experience at Orange Coast Memorial in the past, George asked Dr. Mudiyam to perform his spinal fusion surgery there. “The service, the people, the whole hospital are class A,” says George.
The goal of spinal fusion surgery is to stabilize the spine after removal of degenerated discs. Until recently, this required two separate operations. The first involved removing bone fragments from the patient’s hip to use as a graft. The second procedure, which followed immediately, entailed removing the damaged disc and implanting the bone-graft material in its place. Over the next few months, the graft generated new bone, which eventually “welded” the vertebrae together. “For some patients, the hip incision was more painful than the spinal surgery,” says Dr. Mudiyam.
During George’s surgery, Dr. Mudiyam entered the spine through the back and meticulously removed the two degenerated discs. Then he dipped several collagen sponges into a solution of BMP and packed them inside two tiny titanium cages. Placed in the space where the discs once had been, the BMP began generating new bone growth within days, eventually knitting the vertebrae together. In the meantime, the cages acted as stabilizing forces, maintaining the correct space between the vertebrae.
In the past, a spinal fusion required two separate operations. But now, thanks to recombinant human bone morphogentic protein, only one surgery is necessary.
