From wheelchair to walking: how spinal surgery helped one patient walk again

At 61 years old, Jerry Patton was used to falling all the time. What started as a challenging recovery from a previous knee surgery, Patton thought it was his weakened knee causing him to fall several times a week.

Over time, his balance and mobility became so severely weakened that Patton ended up in a wheelchair. However, during a physical therapy session for his knee recovery, an observant therapist gave him unexpected advice.

"He saw that my hands were caving in and told me I should get an MRI because he suspected the problem wasn't with my knee," Patton recalled.

The following day, Patton underwent an MRI, where he learned the actual cause of his constant falls: severe cervical spinal stenosis.

The seriousness of his diagnosis meant he needed surgery immediately to stop further progressive degeneration of his neck. Within one week, Patton underwent a Posterior Laminectomy and Fusion, a spinal surgery performed by Buqing Liang, a neurosurgeon at Loma Linda University Health.

Although the surgery was successful, Patton knew his chances of regaining full mobility were slim, and only time and hard work would determine whether he would walk on his own again.

Fear of falling

Before Patton learned the truth behind his falls, he attributed his balance issues to not just his weak knee but also to an ulcer on the bottom of his foot, which developed due to his diabetes. However, during treatment for his knee and the ulcer, he noticed that in addition to losing his balance, he started having challenges maintaining his bladder.

During that time, Patton said that everything was going from bad to worse.

"I remember being at the doctor's office, stepping out of my truck, and falling flat onto my face. My feet and legs did not work."

His constant falling led to a severe fear of standing, even for a few minutes, out of fear of losing his balance.

Unexplained spinal cord injury

After discovering that his condition was caused by a spinal cord injury that had been slowly worsening over several years, Patton's symptoms progressed to the point where he was paralyzed from the waist down.

"The spinal cord is the main pathway that connects the brain to the peripheral nerves, which control movement and transmit sensations from the arms and legs," Liang explained. "When the spinal cord is injured, everything below that point can be affected, including both motor and sensory functions."

In Patton's case, Liang said it's not typical for a neck injury to cause isolated knee pain. However, he points out that if someone isn't walking properly because of weakness or balance issues, they might put extra strain on their knees, which could have been the cause of Patton's significant discomfort.

Additionally, Patton doesn't recall having an injury to his neck, but looking back, a lot of the symptoms he'd experienced for several years -- poor balance and bladder control -- were due to his undiagnosed spinal cord injury.

Life-altering surgery

To treat Patton's severe cervical spinal stenosis, Liang performed a two-part surgery using a posterior approach. The procedure began with a laminectomy -- removing part of the bone at the back of the spinal canal to relieve pressure on the spinal cord and create more space. This was followed by a fusion, where screws and rods were placed to stabilize the spine after the bone was removed.

This approach eliminates the need for a neck brace after recovery, though it could make the neck stiffer since the fused levels no longer move independently. That stiffness is a normal and expected side effect of spinal fusion surgery.

Ultimately, the main goal of surgery is to prevent the patient from getting worse.

"If we perform the procedure soon enough, there's a very good chance the patient will improve," Liang said. "Without surgery, the spinal cord sustains more injury over time, leading to increased weakness and loss of function. Eventually, patients could become completely paralyzed and lose their quality of life."