Tony Brown, MD
Tony Brown, MD is a vascular and interventional radiologist in Denver, CO
March 1, 2022doctors, spine jack, treatments
Spine Jack Procedure Gets Entrepreneur Back to Work
Spine Jack Procedure Gets Entrepreneur Back to Work
After a debilitating ski accident, Ben Davis trusted his instincts — and found a surgeon he could believe in.
Written by Pam Moore; Reviewed by Tony Brown, MD
During that dark time, no one could tell him what was wrong. With a doctor who left him with more questions than answers, Ben could only watch as his bank account and his health deteriorated. Looking back, he says he never would have found relief had he not listened to his instincts.
‘Just a Little Too Fast’
On February 4, 2021, Ben was with friends at Copper Mountain in Colorado when he lost control of his skis. An avid backcountry skier with plenty of experience, he says it was a total fluke, “nothing cool or a good story.” As he recalls, he “just went a little too fast” on a groomed intermediate level trail. He estimates he fell from about 20 to 25 feet before landing on his tailbone. “I basically folded in half,” Ben tells SpineUniverse.
The pain was so severe, he left his car at the resort and had a friend drive him home. Although he tried to convince himself he’d just had the wind knocked out of him, he remembers telling his friend, “I think I hurt myself pretty bad.”
In the morning, Ben made the two-plus hour trip home to see his doctor, who diagnosed him with compression fractures at T7 through L2 and an anterior collapse of T11 and L2. His doctor gave him the option to wear a back brace if he wanted, but said there was nothing he could do for Ben.
Unheard and Unhelped
Ben felt his doctor was quick to assume he was drug seeking and didn’t take his pain seriously. “He brushed me off like I was nothing,” he says. In the coming months it would become clear the orthopedic surgeon had issued what Ben calls “a severe misdiagnosis.”
Despite the persistent, excruciating pain, Ben’s doctor insisted his images and physical examination revealed no major findings. And while Ben was skeptical, he trusted the orthopedist. He’d been a patient in that practice for 13 years through multiple injuries and always felt the physicians had his best interest at heart.
After taking eight full weeks off from work, he tried to go back but was in “incredible pain.” As a window washer, his job is physically demanding, requiring frequent climbing, lifting, bending, twisting, and overhead reaching — all the movements that tend to exacerbate back pain. Ben recalls working one or two consecutive days, having to take five days off to recover, and growing increasingly frustrated. “I didn’t understand why I wasn’t feeling better,” he said.
The First Clue
Three months after the injury, in May 2021, desperate for answers, he requested a second MRI. This time it showed significant inflammation at T11, which he’d later learn was a tell-tale sign of a non-union fracture — and the culprit behind his unrelenting pain. Meanwhile, his doctor noted an “unusual amount of inflammation,” said he still couldn’t help him, and referred Ben to a pain specialist.
Initially hopeful, Ben got “a very bad vibe” from the new doctor almost immediately. “The office never answered the phone and had no clue about me or who I was meeting with.” But with frequent low back muscle spasms and nine out of ten pain, Ben was nearing the end of his rope. So when the pain specialist suggested a kyphoplasty, he scheduled it.
Unable to shake his bad feeling, Ben ended up cancelling the procedure just a few days before he was supposed to go under the knife. “There were all these red flags that said I should get out of there.”
He then called Peter Syre, MD, a neurosurgeon whom Ben’s brother, a prominent plastic surgeon himself, had recommended from the outset. Though he was still in intense pain, for the first time in months, Ben started to feel hope. Right away, Dr. Syre recognized the issue and sent Ben to Tony Brown, MD, the same surgeon Dr. Syre referred his own mother to.
A Surgeon to Trust
As soon as he saw Ben’s images, Dr. Brown, a vascular and interventional radiologist at RIA Endovascular in Denver, knew exactly what was going on. Although most of Ben’s vertebral fractures had healed well, Dr. Brown says the T11 fracture didn’t. “Rather than simply compressing, his vertebrae had a split through it. The bone healed on either side of the split, but the bone did not unite. This non-union meant that when he would move, the bone fragments would also move, resulting in pain.”
Ben knew right away that he was in good hands. “[Dr. Brown] came across not as arrogant but very confident.” After seeing Ben’s images, Dr. Brown urged Ben to get to the operating room as soon as possible. Although they met in person for the first time just 15 minutes before surgery, Ben trusted Dr. Brown completely. “Someone was finally taking me seriously,” he remembers.
The Spine Jack
On June 10th, 2021, Ben underwent a Spine Jack procedure. According to Dr. Brown, Spine Jack is a titanium implant that’s inserted into a fractured vertebral body. It then expands like a car jack to push the bone back into an anatomic position. Once the device is expanded and the fracture is reduced (that means the fractured sections are lined up and ready to heal), your surgeon infuses bone cement to fixate the vertebral body. Designed to treat osteoporotic and traumatic fractures, it’s placed into the bone via needle access, much like a kyphoplasty.
But, Dr. Brown explains, whereas in a conventional kyphoplasty the bone cement is infused into the broken bone and the bone is fixated in place without addressing any deformity from the fracture, Spine Jack can put your vertebra back to its normal position. “Data from the SAKOS trial showed us this results in better functional recovery, better pain relief, and more freedom from new fractures,” says Dr. Brown.
And while kyphoplasty might have worked for Ben, Dr. Brown says Spine Jack was the superior choice. His bone had tried to heal the fracture and became very dense in the process. “Dense, calloused bones can be very recalcitrant to kyphoplasty as the balloons are soft — and [therefore] don’t expand to create space, and cement doesn’t infuse to adequately fixate the bone.” And in that case, patients don’t get the relief they need.
According to Dr. Brown, the Spine Jack procedure generally takes no more than an hour while patients are under conscious sedation or anesthesia. He says most patients go home with mild oral pain medication and muscle relaxants and instructions to start moving right away, including normal activities and physical therapy in the following weeks.
Surgery and Aftermath
Ben felt noticeably better just two days postoperatively and has continued to improve since. Through the summer and fall, he gradually increased his work schedule and also underwent nerve ablation, which played a significant role in his pain management.
Today Ben has a 2021-22 ski pass. While he’s not sure how much he’ll be able to use it, he’s cautiously optimistic. And though he’s happy to be in a much better place than he was after the accident, Ben wishes he hadn’t waited months to reach out to his brother’s referral. He says he gets angry just thinking about the time he spent in agony while his business floundered and his doctor ignored his concerns.
Despite the fact that he’d never heard of Spine Jack before meeting Dr. Brown, he knew “one hundred percent” that he’d found the right person. Now, for the first time since his accident, Ben is able to work a full eight-hour day without having to spend the evening curled up in pain.
Instead of canceling clients, he’s booking appointments months out. He has plans to return to Breckenridge, Colo., where he spends his winters. He also has some advice to other patients: Go with your gut.
Original Article: https://www.spineuniverse.com/conditions/spinal-fractures/spine-jack-procedure-gets-entrepreneur-back-work