Jerry Bouche was standing in the shower when he first felt the pain shooting through his legs in 2017. “Well,” the 47-year-old thought, “it sucks getting old.” But for a property manager whose job demands miles of walking every day and a dad who enjoys working on cars in his downtime, even minor back pain can be a serious problem. Little did he know, this was only the beginning of a long battle with degenerative disc disease.
At first, Bouche’s doctor thought muscle tightness could be the culprit. But when Bouche said that his big toe was going numb too, it became clear that something was affecting the nerves. He sent Bouche to Dr. Ashvin Patel, a spine surgeon at Kennedy-White Orthopaedic Center.
“We always try non-operative care first,” says Dr. Patel, who, after a series of MRIs, determined that Bouche was suffering from severe spinal stenosis, or a narrowing of the bony passageways that nerves travel through. As a result, the nerve was being pinched or disturbed, causing Bouche’s pain and numbness. But when physical therapy, anti-inflammatories and other conservative approaches did not alleviate the pain, surgery became inevitable. It would be the first, but not the last.
“They rotor-rooted me,” Bouche says today with a laugh, a colorful description for what spine surgeons like Dr. Patel call a laminectomy, or a widening of the passageways that have been narrowed by stenosis. “And that held for about three or four years,” says Bouche, who enjoyed a return to his active lifestyle, walking his properties and fixing up cars for his kids or just for fun. But in 2020, the pain returned with a vengeance.
Worse than it was in 2017, the pain was now nearly debilitating. “I couldn’t even stand in the shower for three minutes,” says Bouche, and walking any sort of distance became impossible, needing to stop and take the pain off his back every 300 feet or so. “As soon as I started walking,” he says, “the first thing my eyes were looking for was the next place to sit down.” He couldn’t even work.
After a series of scans, Dr. Patel confirmed that Bouche’s discs had continued to collapse, trapping the nerves and causing the extreme pain. “Think of it like a mechanical problem,” Dr. Patel said, and he suggested a two-part surgery—an anterior and posterior fusion—partially guided by a new robotic navigation system that would place the necessary screws in Bouche’s spine with machine precision. “I’m used to fixing cars,” Bouche said. “Put me up on a lift and do what you think is best.”
Fusions have been done for a long time. The basic gist is that collapsed discs are replaced by interbody cages, which act as spacers between the vertebra, just as the discs did. Eventually, bone will naturally grow through these hollow cages, allowing the fusion that re-strengthens the spine. To maintain stability and assist with healing, the surgeon implants rods and screws that keep everything in place. Normally, these screws are all placed by hand, but at Sarasota Memorial, Dr. Patel and his surgical partner Dr. Robert Knego, spine neurosurgeon, are now using the ExcelsiusGPS spine navigation system to place the screws for them. Equipped with a detailed scan of the patient’s anatomy, as well as the surgeon’s surgical plan, the ExcelsiusGPS works with pinpoint accuracy on each patient. “You can be a lot more precise,” says Dr. Patel. “Screws are perfectly placed, exactly where I want them.” This is especially important for patients with small or delicate bones, such as the elderly.
Bouche had the first part of the surgery on a Monday, the second on a Wednesday and he was discharged by Friday. The first few weeks were rough, he admits, using a walker and being careful not to bend, twist or lift anything, changing the dressings and sleeping on a recliner because crawling in and out of bed was more difficult. “But every week, I got better,” he says. “You can’t rush the recovery.”
Today, little more than a year from the surgery, Bouche is back on his feet, working his job, fixing up cars, walking multiple miles a day and even moving too fast for his children sometimes. He’s even back on the elliptical and lost 50 pounds. And while it hasn’t always been an easy journey, Bouche is happy with the results.
“I would recommend Dr. Patel to anybody going through what I went through,” he says.
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Written by Sarasota Memorial copywriter Philip Lederer, MA, who crafts a variety of external communications for the healthcare system. SMH’s in-house wordsmith, Lederer earned his Master’s degree in Public Administration and Political Philosophy from Morehead State University, KY, and isn’t doing his back any favors.