Back pain is one of the most common complaints doctors hear from patients. Approximately 65 million Americans report recent bouts of back pain and 16 million experience chronic back issues.

Back pain is a leading cause of work absences and limitations, and accounts for $12 billion spent on healthcare treatment and indirect costs in the U.S. The pain can be so severe that surgery is the only option remaining for patients who want relief. That’s what happened to Ginny G. In 2007, she experienced an onset of back and leg pain accompanied by numbness and tingling.

An MRI showed junctional stenosis and a synovial cyst. Stephen R. Goll, M.D., one of the board-certified orthopaedic surgeons at Orlando Orthopaedic Center, specializes in complex spinal surgeries. In 2008, with Dr. Goll’s help, Ginny underwent surgery to correct these issues. She fully recovered and is pleased with the results. Today she says, “The biggest benefit from this is that I get to work full time–I can even work out on my Bowflex and have a great, busy, playful life with my husband, Tim.”

What is Junctional Stenosis and Synovial Cysts?

When he diagnosed Ginny with junctional stenosis and a synovial cyst, Dr. Goll realized that he would have to treat two diagnoses at the same time. The diagnoses that Ginny suffered from can be broken down into:

  • Junctional stenosis
  • Synovial cyst (in the L3-4 Left portion of the spine)

Junctional stenosis is “one of the greatest challenges in spinal deformity surgery.” The condition causes a narrowing of the hollow cavity within the spinal column at a juncture between the bones. To understand this, you must first understand that the spine is hollow and functions as a support column for the entire structure of our bodies.

Your spine resembles a long tube that runs from the base of your skull to your tailbone. 31-pairs of nerves run throughout the structure and carry signals from the brain to the rest of the body. When the bony spinal structure develops stenosis, it begins to narrow. This narrowing can pinch and put pressure on the nerves. 

The spinal column is one of the most difficult areas of the body to repair because of the complexity of the structure. Ginny’s diagnosis was particularly challenging to treat because she developed synovial cyst syndrome in addition to junctional stenosis. 

A synovial cyst can cause spinal stenosis when the fluid-filled sac develops around the spine, slowly pinching off the vital structures in the column. It often occurs in older patients and is almost always located in the lower part of the spine.

The final part of Ginny’s diagnosis includes the term “L3-L4,” which refers to the location of the spinal degeneration. The L3-L4 segment of the spine is located in the lumbar area of the spinal column, which forms the lower back. While the spinal column itself is a hollow tube, on the back of the column are vertebral bones and intervertebral discs, along with blood vessels, ligaments, nerves, and muscles. There are 33 stacked bones along the spine and each vertebra is numbered. Together, this series of interlocking bones allow you to move freely. Between each bone are shock absorbers called intervertebral discs. The L3-4 segment of the spine controls the structure in the lower lumbar back region, which bears the full weight of the body. When you lift something heavy with your back (and not your knees), your lumbar spine absorbs the added stress.

Symptoms of these conditions include:

  • Leg, calve, or buttock numbness
  • Calf cramps when walking
  • Pain that radiates into both legs and thighs
  • Weakness in these areas

Now that you understand Ginny’s diagnosis, you may wonder how these problems developed. Both conditions resulted in the slow deterioration of Ginny’s spinal column, causing numbness and tingling in these areas. But what causes this type of spinal degeneration?

What Causes Spinal Degeneration?

Spinal degeneration can occur naturally from aging. Over time, arthritis impairs the normal functions of the spinal column, and the bone or intervertebral discs gradually wear out. These issues can also result from spinal injuries and can develop infections or tumors in this critical area of the body. 

Physicians can diagnose spinal degeneration with X-rays, magnetic resonance imaging (MRI), or computed tomography (CT). If diagnosed, your doctor will determine the best course of treatment. In Ginny’s case, her only option was surgery. When faced with a serious operation, Ginny says, “Do your research. I chose Dr. Goll and I knew he would take care of me. I knew everything would come out fine.” After a thorough examination, Dr. Goll chose a treatment known as lumbar decompression and fusion, which he knew could help Ginny get her life and health back.

What is Lumbar Decompression and Fusion Surgery?

Lumbar decompression and fusion surgery is a procedure that alleviates the pressure caused by the narrowing of the spine. At the same time, the surgery fuses the vertebrae to provide additional stability in the spinal column. Lumbar decompression and fusion surgery is often the last resort for patients who try non-invasive and conventional therapies, but fail to find relief. Today, this procedure can be relatively non-invasive, since the technology has evolved to allow for smaller incisions and state-of-the-art instrumentation. Minimally invasive procedures can lessen the trauma to surrounding tissues and have many benefits, including faster healing, less blood loss, and a more positive patient outcome. 

Lumbar decompression and fusion surgery helped to relieve Ginny’s suffering. She says her recovery has been dramatic, “I can carry heavy groceries and I can even carry boxes of heavy water on my shoulders like I used to do as a banquet server.” Her positive experience and outlook are shared by many of Dr. Goll’s patients who also benefited from the surgery.

If you’re suffering from back pain, numbness, or difficulties performing routine tasks, Ginny says, “I would definitely recommend Dr. Goll. It’s like he’s given me a new life. I have the confidence to do anything.”