October 24, 2006

(SACRAMENTO, Calif.) — Phyllis Eres is passionate about golf. She plays a few times each week and, at recent golf tournaments in Northern California and Oregon, she finished first and second in her classification.

But before undergoing surgery earlier this year, Eres had endured back pain for so many years that she thought she might never play her beloved sport again.

“I went through every kind of physical therapy,” Eres said. She also had ultrasound treatments and saw a chiropractor. Whatever she tried, nothing worked. The injury “caused me to lose the feeling in both my legs and feet,” she said. “I was always in excruciating pain. I couldn't stand on my feet long enough to do housework or go shopping.”

Eres' is playing golf again after undergoing an innovative surgical procedure at UC Davis Medical Center, performed by Kee Kim, chief of spinal neurosurgery, associate professor of neurosurgery and co-director of the UC Davis Spine Center. The procedure, known as dynamic stabilization, involves the insertion of a flexible rod into the spine instead of a traditional, rigid model.

In dynamic stabilization, a device consisting of external spacers is attached to either side of the affected vertebra. The device stabilizes the joints, helping to keep the vertebrae in a more natural position while leaving the spine itself intact. Made of flexible materials, the device permits a controlled range of bending, straightening and twisting movement in the affected joints.

The procedure may give some patients a surgical option that allows them to maintain some flexibility and function while reducing pain, according to Kim. Spine surgery more commonly eliminates pain by reducing motion and flexibility. For example, lumbar fusion surgery, a common procedure for low back pain or degenerative disease, fuses adjacent spinal discs together and frequently reduces back pain, but it also reduces the flexibility and motion of the spine. Fusion surgery also transfers additional stress to joints above and below the fused levels, which may lead to accelerated degeneration.

Dynamic stabilization may be appropriate for patients with spinal stenosis and spondylolisthesis, or for a very select group with painful disc degeneration. In spinal stenosis, compressed nerves cause pain, numbness and tingling in the legs. Spondylolisthesis (commonly known as a “slipped disc”) is a condition where excessive or abnormal movement of the vertebrae causes pain in the low back or legs. The most common surgical treatment is to fuse the misaligned levels.

Because Eres had spinal stenosis and a misaligned spine, and wanted to maintain an active lifestyle, she was an ideal candidate for dynamic stabilization, which would prevent further slippage, Kim said.

“I wanted to preserve her flexibility and movement so she could return to playing golf,” he said. “She's among the growing population of 'baby boomers' who still want to be very active and do the things they enjoy. In her case, the procedure turned out to be a very good choice.”

Kim anticipates using dynamic stabilization increasingly on select patients to relieve their pain. “It won't totally replace fusion surgery, but there definitely are a certain number of patients who will benefit from this new procedure,” he said.

“When I woke up in my room after surgery, I felt absolutely no pain,” she said. “It was just amazing to me. I didn't know how to act. I had refused to take narcotics all my life, so for years I had just learned to live with the pain. The surgery has given me my life back. I would recommend this operation to anyone with sciatic problems. I give all the credit to Dr. Kim for finding the right solution for me.”

The UC Davis Spine Center was established to help patients such as Eres. The interdisciplinary program is designed to help patients of all ages and stages of dysfunction caused by spinal disorders to return to their optimal level of functioning.

Consultation and treatment services provided by the spine program include: neurosurgery; orthopaedic surgery; physical medicine and rehabilitation; pain service diagnostics and pain management; group medical visits; physical therapy (individual and group sessions); pool therapy; and a scoliosis clinic.

The multidisciplinary approach to patient treatment “allows surgeons, doctors and specialists to collaborate and seek each other's advice on patient care, vastly improving the care we can provide,” Kim said.

In November, the UC Davis Spine Center will be the first in Northern California to house surgical and non-surgical specialists under the same roof, at the Cannery Business Park at 3301 C St., Sacramento.

“It will be a great asset to patients with any type of spine-related problems,” Kim said.