Patient Has Less Pain after Life-Changing Spinal Stenosis Surgery

What would it be like to live pain free? That question crossed Dan Owens' mind numerous times as he lay in bed for nearly a year. Dan suffered excruciating back pain, barely managing to make his way between the bed, a nearby bathroom, and a chair only feet away.

"If pain is measured on a scale from one to 10, I was at 20," Dan says. "I tried everything to find relief."

Dan had always been active, leading an ambitious lifestyle focused on providing for his family. Work in the retail industry meant large amounts of travel and long days on his feet. Dan jokes he often felt invincible. He played sports, began several businesses, and gamely switched career fields as new opportunities arose. But in the late 1990s, Dan began to experience pain in his neck and back.

After a ruptured disc and neck surgery involving fusion and pin placement, Dan describes feeling like "a total mess." He developed neuropathy, a condition in which nerve damage causes pain, numbness, and weakness in hands and feet. In Dan's case, the neuropathy spread to his legs, eventually contributing to his decision to retire from the work he loved.

As his busy lifestyle took a back seat to pain management, Dan threw his remaining energy into treatments such as physical therapy, chiropractic care, massage, and acupuncture. But nothing seemed to help him feel better. Soon, Dan was managing only a few steps per day using a walker for assistance. Dan's zest for life began to falter, and his family was fearful of his rapid decline.

At his lowest point, Dan describes his pain as deeply emotionally and physically distressing, leading to feelings of worthlessness and grief.

"I didn't want this to be the way my life ended," Dan recalls. "I couldn't leave my home—I was desperate."

He had seen several physicians in his hometown but felt like none offered comprehensive solutions to fully manage his condition. Dan and his family were confused and discouraged by differing diagnoses and treatment plans.

In August 2018, Dan was referred to Dr. Marcus Mazur, a surgeon focused on complex spine disorders at University of Utah Health's Clinical Neurosciences Center.

"When I met Dan, it was clear he was in a tremendous amount of pain," Dr. Mazur says. "He also had weakness in his legs and difficulty with his balance. He was hoping we could work a miracle, and fast. But first we needed to identify the root of the problem."

Dan was surprised to learn surgery wasn't the first option. Dr. Mazur recommended tackling pain management first, explaining Dan would handle a complex surgery better if his pain was under control and his body was gaining strength.

"Dr. Mazur explained the problem in a way we could understand," Dan says. "There was no quick fix, but I saw action in his desire to treat. He wanted to do it the right way, and I trusted that."

After a battery of tests and imaging, Dr. Mazur diagnosed Dan with previously unidentified scoliosis, but still wanted to pinpoint the neurological cause of Dan's most severe pain so it could eventually be treated through surgery.

Dr. Mazur immediately recommended water-based physical therapy to recondition Dan's muscles, which had severely atrophied after months of being unable to move properly. The two met several times over the course of three months to evaluate Dan's pain and progress. Dan's pain was slightly improved, but he was still experiencing abnormal weakness. An MRI revealed spinal stenosis, or severe narrowing caused by arthritis and degenerative disk disease, which exerts pressure on the spinal cord and nerves. Dan's stenosis was located at the T12-L1 vertebrae, contributing to his leg weakness, loss of balance, numbness, and debilitating pain.

Dr. Mazur methodically mapped out surgery with Dan, choosing to optimize relief by focusing on decompression of severely arthritic facet joints and removal of the herniated disc material. Since removing facet joints can cause instability, Dr. Mazur would fuse the spine after releasing the constricted area.

"Our options were to either treat his scoliosis, which would require an extensive 8-level spinal reconstruction and several months of rehabilitation, or treat just the most stenotic level, which would require a 1-level operation and a much shorter recovery," Dr. Mazur explains. "Although the smaller operation might seem more appealing from a recovery standpoint, it carries the risk of potentially causing the scoliotic deformity to worsen over time. We didn't want to do an operation that would lead to a lengthy recovery, but we also wanted to avoid negatively affecting Dan's spinal alignment."

Dr. Mazur and his surgical team performed a posterior decompression and fusion operation, using an open approach (incision) to clearly view Dan's spine anatomy and extent of compression. Dan's spine was rotated from scoliosis, making this intricate surgery even more complex. Dr. Mazur placed screws in the T12 and L1 vertebrae to stabilize the spine. He artfully maneuvered around the spinal cord to remove the arthritic joints causing spinal cord compression from the back, and extracted the herniated disc exerting pressure from the front. Once the spinal cord was free from pinching disc fragments and overgrown bone, Dr. Mazur finalized the operation by placing the patient's own bone alongside the instrumentation so the T12 and L1 segments could fuse together and provide stability to the decompressed area.

Most patients undergoing similar surgeries remain in the hospital for around four days, beginning basic physical and occupational therapy the day after the surgery. Patients require approximately four to six weeks to recover, and typically regain pre-surgery function in six to 12 weeks.

Dr. Mazur cautioned Dan to retain realistic expectations about movement and recovery, but Dan feels like he got his miracle after all. The day following surgery, Dan noticed the absence of tingling and numbness in his legs, and was able to stand and walk.

"For the first time in recent memory, I could feel my legs," Dan recalls. "I could even get up and walk—but I felt like dancing. I was elated."

Dan continued to build strength and coordination through regular physical therapy, regaining full use of his legs. His scoliosis remains stable after surgery, and Dr. Mazur will continue to monitor it closely over time.

"The surgery helped Dan a lot, and he's put in his share of the hard work to recover," Dr. Mazur says. "He'd lost a lot of conditioning and muscle tone after being bed-bound for 12 months. Dan made a conscious decision to improve. It takes a lot of focus and determination. He's completely turned around."

For now, Dan says the future is looking up, and he plans to appreciate his retirement the way he originally intended. He and his wife of 37 years just bought new cruiser bikes and invested in a home treadmill to stay healthy. He's excited to swim, take short hikes, travel, and dote on his grandchildren.

"I've always wanted to keep working and stay busy," Dan says. "Now there's no limit to what I can do. I can enjoy my life and my family. It feels great to be fit."

Both Dan and Dr. Mazur encourage anyone experiencing debilitating pain to seek help. With fully coordinated resources to diagnose spinal pathologies, build a comprehensive treatment plan, and provide both non-surgical and surgical spine care, U of U Health's Clinical Neurosciences Center can help.

Dan cites Dr. Mazur's calming, thorough approach, which built trust and helped him feel confident about undergoing surgery.

"We knew Dr. Mazur had a plan and would do his best because he had the ability, tools, and training to do the job," Dan says. "Our prayers were answered."