Innovative back surgery helps retired nurse eliminate pain and recover function

Elizabeth Schuber has recovered her quality of life after an innovative back surgery that relieved her of ongoing pain and brought back her ability to perform daily tasks.

Surgeons at Loma Linda University Health performed a lumbar fusion on the 68-year-old retired nurse without cutting through her spinal muscles. Instead, they performed a muscle-sparing lumbar fusion utilizing tubular dilators to separate rather than detach the multifidus musculature.

"The multifidus muscles that run along the spine are very underappreciated in helping a person maintain balance. If a surgeon cuts through that muscle tissue, that muscle disruption can lead to scarring, atrophy, and postoperative dysfunction, whereas muscle preservation may improve recovery," said Namath Hussain, MD, MBA, a neurosurgeon at LLUH who performed Schuber's procedure.

These muscle-preserving techniques have gained increasing adoption internationally, particularly in South Korea, where many surgeons have helped pioneer advanced minimally invasive approaches, Hussain said.

"Very few centers in the United States are doing this type of advanced endoscopic work with a tubular dilator," he said.

Schuber now wants to share her story because she wants people to know there is hope for recovery from back pain in ways that weren't possible even just a few years ago. For her, the before-and-after contrast has been life-changing.

"It's been unbelievable for me," she said. "It's a night-and-day change. It's a 100% improvement. I don't have any back pain whatsoever. If I can encourage someone to get this procedure if they need it, that would make me feel so good. The lease on life they would have would be so incredible."

Originally from Britain, Schuber worked as a nurse before moving to work in Saudi Arabia. There she met her husband, an American, where they lived for a few years before moving to South Korea and later Southern California.

Working as a nurse before the implementation of electronic lifts required more physical exertion, Schuber said. In her 30s she ruptured a lumbar disc, which caused some paralysis in her right leg and required emergency surgery.

Surgeons removed that ruptured disc, but she later underwent more lumbar degeneration in her spine to the point that she was in agony every day.

Schuber came to LLUH last year because she was experiencing pain while performing even the most basic life tasks, such as getting in and out of a chair or bed. Her husband had to help her get dressed.

"I said, 'That does it! This is no quality of life,'" she remembers thinking at the time.

At LLUH, imaging had demonstrated spinal instability and degeneration after years of failed conservative treatments. Surgeons explained their plan to perform a procedure using the minimally invasive approach.

Hussain said he remembered her being leery of another back surgery and recovery because of her age. But he explained the proposed method with diagrams and charts and answered her questions about recovery and pain control. "She asked a lot of good questions. She was very informed as a nurse," Hussain recalled.

Hussain and his team performed the procedure, and Schuber stayed in the hospital for three days for inpatient recovery. She says the nursing staff during that time were "second to none," and her husband appreciated the text updates from the staff during her procedure.

Now fully recovered, Schuber says she enjoys her time gardening, taking walks with her husband, and seeing the beauty of the mountain region around her home in Big Bear City.

"I'm very grateful because it's given me the gift of quality of life back. It's incredible," she said.

The minimally invasive approach to endoscopic surgery is now a common procedure that LLUH performs, given that many patients suffer from degenerative disease of the spine.

To learn more about minimally invasive endoscopic procedures, as well as other spine and neurological approaches to care, contact us at lluh.org/neurosurgery.