Expert Spine Care Restores Libertyville Man’s Dynamic Life

Karl Miller personifies a man on the go. As a construction contractor who plays a role working on “power projects,” Miller, 50, is a lifelong athlete who had regularly enjoyed bicycling, skiing, running and logging up to two hours daily on an elliptical machine.

Eleven years ago, however, Miller felt his hip freeze up. “My leg got tingly,” he recalled. This was the beginning of continued similar episodes of pain and immobility that began to slow him down and impact his active lifestyle. NorthShore orthopaedic surgeon Mark Nolden, MD, of the NorthShore Spine Center, was able to intervene, allowing Miller to once again pursue his favorite athletic activities.

The pain that Miller experienced crept up on him gradually. While it was a nuisance, it did not interfere with his lifestyle until the last two years. He could accept changes to his fitness routine, but then the pain began affecting his everyday life. Back and neck pain are among the most common causes of disability in the United States and are often recurring and increasingly limiting for those who, like Miller, suffer from a pervasive problem.

“My leg would go numb after a 10-minute walk,” he said. Miller travels extensively for his job, averaging 130 flights a year. The pain had progressed to a point where he could not make it through the length of an airport terminal unless he sat down midway.

Miller continued to live with the pain— nearly immobilized—until his primary care physician referred him to Dr. Nolden at the NorthShore Spine Center. Miller recalled he felt an instant rapport and became hopeful about resuming his athletic activities and getting his life back to normal.

The NorthShore Spine Center is a collaborative program that combines the expertise of neurosurgeons, orthopaedic surgeons and physiatrists in the NorthShore Medical Group. The Center offers patients a coordinated, conservative approach to treat a wide array of back and neck conditions as part of the comprehensive spine care services offered at NorthShore.

“The fact that rehabilitation specialists are working side-by-side with neurosurgeons and orthopaedic physicians really differentiates this program,” said Joseph Alleva, MD, a physical medicine and rehabilitation expert with an academic appointment at the University of Chicago Pritzker School of Medicine. Dr. Alleva and Dr. Nolden are two of the lead physicians of the NorthShore Spine Center and are supported by a host of spine specialists across the NorthShore system. NorthShore’s sophisticated Electronic Medical Record (EMR) system completes the seamless communication essential to the Center’s collaborative synergy.

The spine specialists at NorthShore begin treatment with the most conservative approach possible, using nonsurgical options whenever appropriate. From physical therapy to interventional procedures, such as epidural steroid injections in the spine, to integrative medicine treatments that include acupuncture, patients have access to a full complement of therapeutic options.

“Conservative treatments are always the first choice in managing back and neck pain,” said Dr. Nolden. “We manage the pain for as long as we can and for as long as a patient can tolerate it. Then the decision to have surgery, if necessary, is made by the patient.” When surgery is the best option, expert spine surgeons care for patients with the latest technology and techniques, including advanced, minimally invasive procedures.

In Miller’s case, by the time he saw Dr. Nolden, he had reached the point where a conservative approach was no longer an option. “Karl had been an active person who wanted to be active again,” said Dr. Nolden.

Radiographic studies, including an MRI and CT, showed Miller was suffering from lumbar degenerative scoliosis. This was complicated by a condition called isthmic spondylolisthesis in his lower back. The joints that linked his spine together were deteriorating and causing it to curve. In isthmic spondylolisthesis, one vertebra slips forward onto the level below because of a break in the roof of the spinal canal and disconnects the front of the bone from the back. This resulted in compression on two major nerves traveling to Miller’s leg and the relentless pain he had been experiencing.

Dr. Nolden reconstructed a portion of Miller’s spine where deterioration had occurred both to relieve the pain of compressed nerves and to straighten and strengthen the spine. He removed a portion of the spine’s joint, inserted a disc spacer and fused together three vertebrae (transforaminal lumbar interbody fusion).

He also removed a significant amount of arthritic bone to relieve pressure on the nerves to Miller’s leg. Reflecting the expertise of the NorthShore Spine Center staff, Dr. Nolden said, “This was a reconstructive procedure we commonly do as spine surgeons.”

“Dr. Nolden told me, ‘I’ll let you get active if you follow postoperative restrictions closely,’” said Miller. “I did everything I could to be a textbook patient. The day after surgery, I was walking up and down steps.”

Miller was back at work two weeks after surgery and could work out for 45 minutes on the elliptical machine. Three months later, he was given clearance to ride his bike outside. This summer, Miller and his family attended the London 2012 Olympics. “I was really looking forward to that. We went four years ago in Beijing, and I could barely get around,” he said. Also on his “to do” list are hiking and skiing later this year with his daughters who attend college in Colorado.

“Karl was very motivated, and that worked in his favor,” said Dr. Nolden. “He took all the advice we gave him, and it played a role in his rapid recovery.”

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