Joya's story
Scoliosis, spinal deformity surgery
Traveling to Cincinnati for spine surgery proves beneficial for Joya
From her home in St. Louis, Joya worried that she had exhausted her options to battle the debilitating pain and weakness in her lower back, hips and down both legs. The career hairdresser found herself sitting down between appointments. She had tried pain injections and physical therapy. Eventually, she started using a cane.
It was exhausting.
Joya with her friend from Mason
"As time went on, it just got worse and worse," she says. "When I saw my scans, I wondered how I was even standing. I was shocked at how my spine looked."
Then came her breakthrough. During an extended visit with her a close friend in Mason, someone recommended that Joya call Mayfield Brain & Spine. She thought, "Why not?" and made an appointment at the Cincinnati-based neurosurgery practice. There, she met Mayfield neurosurgeon Dr. Michael Kachmann.
When Dr. Kachmann looked at Joya's magnetic resonance imaging (MRI) scans, he saw that she was suffering from severe degeneration at multiple levels of her spine. Surgery would be challenging, but Dr. Kachmann was confident that Mayfield had the expertise to get her back to living a normal life.
"Patients with the symptoms Joya was suffering often have little hope that they will ever get relief from the pain," Dr. Kachmann says. "She needed a global solution, not simply repairing the damage at individual levels of her spine. At Mayfield, we are equipped to handle just these kinds of cases."
When Dr. Kachmann recommended surgery, Joya did not hesitate.
"That was all I needed to hear," she says.
Joya and Dr. Kachmann
Collaboration among experts leads to positive outcome for Joya
After those initial consultations, Joya traveled back home to St. Louis. She had several virtual appointments to discuss surgical options before returning to Cincinnati for the surgery.
In the interim, Dr. Kachmann consulted with his colleague, neurosurgeon Dr. Zach Tempel. They are part of Mayfield's Scoliosis and Spinal Deformity team, specializing in complex cases that spread over multiple levels of the spine and include severe degenerative disorders. Those disorders include scoliosis, a side-to-side curvature of the spine; and kyphosis, an abnormal forward rounding in the spine of more than 50 degrees.
Mayfield's care model allows for those kinds of collaborations to bring the full expertise of the independent practice to each individual patient. Dr. Kachmann and Dr. Tempel talked about the levels of Joya's spine that would need significant repairs and the proper corrective angles and approach. They also consulted about the optimal path to Joya's spine with Dr. Brian Kuhn, a vascular surgeon at the TriHealth hospital system, where the surgery would be performed.
"This kind of collaboration to create customized solutions for every patient is part of what differentiates our spine practice at Mayfield," Dr. Kachmann says.
In Joya's case, there were some unique challenges. She had recently given up smoking, which can restrict blood flow and slow natural healing of the bone. She also had fought a melanoma in her leg, and she had suffered a car crash several years before that accelerated her pain.
Most importantly, Joya had undergone breast reconstruction after a bout with cancer, including the use of some muscles in her lower abdomen, called the TRAM flap. In many cases, the physicians would access the spine through the front, called an anterior lumbar interbody fusion, or ALIF. However, since there were fewer muscle tissues in that area, they opted for a posterior approach, accessing the spine from the back.
Joya traveled back to Cincinnati for the surgery. During the procedure, Dr. Kachmann and Dr. Tempel fused vertebrae together at two separate levels of Joya's lumbar spine to decompress the spine and relieve pressure on the surrounding nerves. They then inserted rods and screws to straighten and stabilize her spine from the top of her pelvis to just below the rib cage (T10 to pelvis).
"The posterior approach is a time-tested technique for spinal deformity surgery," Dr. Kachmann says. "We have developed the anterior approach in recent years. Given the loss of muscle tissue that was used for Joya's breast reconstruction, we opted to access the spine from the back. We're not restricted to one method of surgery. We've got a lot of tools in our toolbox."
Today, Joya is back to work and able to do many of the things that she was unable to do before the surgery.
"I had gotten used to the pain," she said. "I'm not exaggerating here, but it's just wonderful to wake up in the morning and not have any pain."
~ Cliff Peale
Hope Story Disclaimer -"Joya's Story" is about one patient's health-care experience. Please bear in mind that because every patient is unique, individual patients may respond to treatment in different ways. Results are influenced by many factors and may vary from patient to patient.
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