Anterior interbody fusion
Surgeon's support prepares ultra-marathoner to run again
Michelle is nearly ready to run again.
Michelle doesn't run like you and I run. As an ultra-marathoner, she'll race 70 miles in a single day. It takes a toll on her mind and her body.
Enter neurosurgeon Dr. Zach Tempel, a spine specialist at Mayfield Brain & Spine. Dr. Tempel operated on Michelle's back in December, fusing together two vertebrae at the base of her spine. A separate hip surgery for a torn labrum two months ago set back her recovery, but now Michelle is feeling the urge again.
In her head, she's hearing Dr. Tempel's mantra: Be patient and take care of yourself, and you can recover to run again.
"He has changed my life," says Michelle, now in her early 30s. "It was a lot more than the surgery. I did well with the back surgery because he prepared me so well. He was brutally honest with me. I honestly feel like Dr. Tempel would be sad if I didn't run."
Dr. Tempel and Michelle have faced some common barriers – both have dealt with symptoms of sepsis, a severe response to an infection. He also counseled her on maintaining and even gaining weight, adding some strength that would help her sustain and recover from the extreme level of activity.
The hip surgery has delayed Michelle's recovery, but Dr. Tempel says that with a combination of the drive that has fueled her running for years, plus a newfound respect for the self-care and preventive measures that can enhance her long-term health, she should be able to return to full activity.
"Running has been a significant part of Michelle's life, and I wanted to make sure we provided her with the opportunity to resume what she loves to do," Dr. Tempel says. "She has responded well to the surgery. She is an inspirational case because she has shown the same enthusiasm for her recovery. Athletes at this level are all about getting over the next barrier, and I have every confidence Michelle will succeed and thrive, just as she has done for years."
Michelle says she always has been active. She was a cheerleader in college and ran her first 50-miler at age 22. She had never had significant back problems, but remembers clearly when she first injured her back – in June 2021 while lifting weights. There was a loud crack and she dropped to her knees in pain. Despite the diagnosis of a fractured vertebra, she continued with a 70-mile run the next month, taking anti-inflammatories during the race.
By later last fall, Michelle's pain level had increased to the point where it was affecting "everything I tried to do." She tried physical therapy, to limited effect. One of the therapists recommended Dr. Tempel, who first examined Michelle in late 2021 and immediately saw a vertebra had slipped out of place at the L5-S1 level of the spine, putting pressure on the nerves and leading to Michelle's back pain. The condition, called spondylolisthesis, led to Michelle's surgery shortly before Christmas at Bethesda North Hospital.
"It's easy to say, 'Stop running,' but a lot more difficult to actually stop," Dr. Tempel says. "Like many athletes, Michelle was convinced she could defeat the pain. But once we saw her, it was clear she had a significant injury. We chose a stand-alone minimally invasive procedure called an anterior lumbar interbody fusion to fuse the L5-S1 segment, avoiding the need to use pedicle screws or other hardware and preserving as much range of motion as possible."
Michelle started to run short distances in May, careful not to overburden herself. After the June hip surgery, she wants to make sure she is healthy before she builds her running routine again.
"I had to kind of start over," she says. "I want to take a year to see what my body can do without pushing it before I race again."
~ Cliff Peale
Hope Story Disclaimer -"Michelle'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.