Just like most of us, Jerry Stark took his physical strength for
granted until the first time it didn't respond the way it always
had—and delivered word of its new status with a sharply-sent message
Stark had spent most of his working life as a house painter in Santa
Rosa, crawling up ladders, over roofs, through attics. Often he was
carrying full five-gallon cans of paint at the same time. It was hard
physical work, but Stark didn’t think twice about it. "When
you're doing physical things all the time, you just keep doing
them," he said. "You never think you won't be able to. It's
just what you do."
He figures it might have been about 20 years ago that he lifted
something "and I lifted it wrong," he said. "I dropped
to my knees in pain and couldn't get up." After a few minutes,
the pain was gone and he returned to work as if nothing had happened,
he said. But many more years as a painter would exact a heavy toll. By
the time he saw Ivan Cheng, MD,
an orthopaedic surgeon at Stanford Hospital & Clinics, he had
endured nearly 30 years of increasing disability from a spine that had
degenerated into a twisted, bent version of its once-straight self and
with it any semblance of a normal life.
"When they asked me at Stanford what my pain level was—they go
by numbers 1 through 10—I started with an 11," Stark said. His
spine was curving into an extreme S shape and sloping forward, too.
Very little about Stark's life was normal, especially since he needed
so much medication for his pain that he felt drowsy most of the time.
Work was out of the question. And small inconveniences symbolized his
deterioration—the day arrived when Stark was so bent over he could no
longer see his face in his bathroom mirror.
like that diagnosed in 6 million others in the United States, had no
definitive cause, although genetics and biology may play some part.
The abnormal curvature of the spine can appear at any time of life.
With age, however, comes the natural degeneration of discs, the pads
of cartilage that cushion the spine's stack of bony vertebrae. Bone on
bone grinding becomes one cause for pain; pinched spinal nerves can
send pain signals down through the legs.
For many, medication and other non-surgical treatments can alleviate
the discomfort caused by scoliosis’ misalignment. For others,
including Stark, the changes caused by the condition may require
surgery. Until recently, such surgery was very risky and could mean
months of hospitalization toward an end result that was not always
positive. Stark, fearful, tried to ignore what was happening to his
body. "I kept thinking, 'You can exist this way. It's not going
to get worse.' Then you look in the mirror, and it is worse. And you
know you have to do something about it."
With these minimally invasive techniques, where we can achieve the same amount of correction, we can minimize the amount of blood loss and the amount of anesthesia - really enhances recovery.
-Ivan Cheng, MD, orthopaedic surgeon, Stanford Hospital & Clinics
"Twenty years ago, there probably would have been a lot of
reluctance to operate on Mr. Stark," said Cheng. "Surgery
for these types of spinal problems often took multiple procedures,
staged over days, with massive blood loss and patients might lay in
bed for six months at a time."
New techniques—and hope
What Cheng and other orthopaedic surgeons now have available are
new, minimally invasive ways to enter the body and new implants
endowed with technology that makes them more reliable. Stark and his
former wife, Pam, who volunteered to be part of his post-surgical
support team, along with his grown children, began to interview
surgeons. At one facility, they waited four hours to see a surgeon;
they liked him but were put off when, after presenting him with some
questions, he directed them to his assistant. They decided they'd seek
a second opinion at Stanford. "I think the longest we waited was
10 minutes," said Pam Stark. "He pulled everything up on a
computer and explained everything. He didn’t hold back. And he said,
'Anytime you need to call me, you can call me.' When we left there, I
told Jerry, 'He's the guy.'"
At 68, with significant spine issues, Stark did present a challenge,
even for an experienced surgeon like Cheng, but Cheng was impressed
with Stark's spirit. "Because of his deformity, he could barely
walk, even with a walker, but he was still a vibrant individual. You
could see that he was very motivated to accomplish a lot more in his
life, that he really wanted to get something done that would allow him
to move on with his life."
In Mr. Stark's first surgery, Cheng avoided the traditional large
incision approach along the spine and, instead, made just three small
incisions along the side of his torso. Through these incisions, in a
relatively short three-hour process, he was able to remove Stark's
damaged discs and replace them with synthetic spacers. "With
these minimally invasive techniques, where we can achieve the same
amount of correction, minimize the amount of blood loss and the amount
of anesthesia—that really enhances recovery," Cheng said.
In a second procedure five days later, Cheng did use a large
incision along Stark's spine to place titanium screws and rods to
complete the straightening and stabilization. Again, the procedure was
relatively short—about five hours.
An active life restored
Cheng had estimated that it might take Stark up to a year to regain
normal function, but at seven months out, it's hard to tell that
anything was ever wrong with Stark. He's been completely disciplined
about his physical therapy and has found delight in returning, with
full vigor, to a full life, right down to details like jeans. Before
his surgery, the curvature in his spine was so extreme he couldn't
fasten a belt around his waist and could only wear sweat pants. Once
he was upright again, one of the first purchases he made was a new
pair of Levis. He also takes some pride in showing off the before and
after X-rays of his spine. "This one shows the extreme curvature
of the spine," he explains. "Everything was moving."
Then he holds up the after image. "This is when Dr. Cheng was
finished. Here's the new Jerry Stark."
He has a few kinks in his mobility yet to work out. "I'm still
in pain at different times, doing different things," he said,
"but I'm so glad I did it. It's like a new life—and I feel good
when I look in the mirror now."