Finally, Back to Health

From the moment Roberta was rolled into the operating room until Ludwig emerged from checking her into the recovery room, the operation took Ludwig and his seven assistants -- nurses, anesthesiologists, neurophysiologists and a physician's assistant-- almost exactly three hours.

The Pain, Gone

When she emerged from anesthesia, Roberta found herself coping with postoperative pain, which is almost always initially severe. But she said it was no worse than what she'd been suffering constantly for the past four months, and now at least it was only in her spine. The pain in her legs and arms was entirely gone, as was the near-lifelong hypersensitivity of her head and neck.

Within 24 hours she was walking shakily to the bathroom. Within a week she was walking two miles with a walker. Within 10 days she had bettered that distance with the help of just a cane. Little more than two weeks after the operation she was walking even further, cane-free and -- with the help of pain pills -- almost pain-free, though she still experienced some discomfort, tired easily and was sleeping a lot.

Ludwig said it would be two months or more before she was fully recovered, in part because her legs had been weakened by her long bout with pain and because it would take exercise and physical therapy to teach her new spine to twist and bend again. Most spinal fusion patients, he said, never entirely recover their preoperative flexibility, but most, he said, rarely notice their slight degree of restricted movement.

Roberta says no one but she can fully appreciate how miraculously the operation has changed her life. "I hate to think of what would have happened had I not found Ludwig. I can't believe so many doctors missed the diagnosis."

Ludwig, however, says it's not that simple. While each year as many as 500,000 people in the United States are diagnosed with spondylolisthesis, each may have different symptoms and some may have no symptoms at all.

"We get patients in here who, when you see their X-rays, you can't believe they're actually walking," he said. "But they're in no particular pain. They get referred by another doctor alarmed at what he sees on the X-ray."

Moreover, Ludwig said, what symptoms do appear may mimic other muscular or neurological conditions that have nothing to do with spinal ailments. There are a lot of patients like Roberta, he said, with symptoms that most doctors can't put their fingers on. They may be spine-related, they may not. The art is in telling the difference.

The four-year-old spinal center at UMMC, he said, sees at least 3,000 patients a year, "and only a small percentage require surgery."

In Roberta's case, Ludwig said, her very specific medical history, the onset and progression of her symptoms, "correlated perfectly with what we were able to see with the X-ray and MRI imagery of her back. And that made all the difference." ·

Ken Ringle, a 33-year veteran reporter for The Post, writes these days from retirement.