Francis "Al" G Back in Business

“Thanks to the surgery, my wife and I are planning an extended trip to the Pittsburgh area for a car show next year.”

Spine surgery has enabled one patient to get back to work — and his favorite pastime.

As a home-improvement contractor for more than 30 years, Francis “Al” Gambony was accustomed to climbing ladders and wielding heavy tools. He was also no stranger to occasional back pain. But last year, Al, 63, discovered he could no longer rely on over-the-counter anti-inflammatory medications to relieve the discomfort, which was radiating to his legs and causing numbness in his feet. He was so stiff when he woke up it took him more than a half hour every morning just to get on his feet and start walking.

“At work, I could no longer lift heavy objects,” says Al, who lives in Hampton. “Kneeling was painful, and bending, twisting, turning and reaching were becoming increasingly difficult. He also couldn’t sit in cars for long periods of time. Road trips caused so much pain and numbness that he had to put his favorite pastime—attending car races and shows—on hold. Al tried physical therapy, but it didn’t help, so he made an appointment with Matthew McDonnell, MD, a spine surgeon at Robert Wood Johnson University Hospital (RWJUH) Somerset. An MRI exam revealed that Al had severe spinal stenosis, a common complication of arthritis, which had caused his spine to curve and some vertebrae, or spinal bones, to shift out of alignment.

People whose jobs involve physical labor often develop advanced arthritis, says Dr. McDonnell. “Spinal stenosis can be very debilitating,” he continues. “The spinal canal narrows, causing nerves to become compressed.” Bony overgrowths known as spurs often put pressure on spinal nerves. In May, Al underwent spine surgery: a laminectomy with a spinal fusion. During the laminectomy, which involves creating more space for the spinal nerves, Dr. McDonnell opened the spinal canal and removed spinal bone to relieve the nerve compression. Then he fused the unstable spinal bones together. To facilitate healing, he placed screws, rods and bone graft materials in the spine.

Al had the surgery on a Friday morning and remained in the hospital until Monday. “I was impressed with the nursing care,” he says.

Walking Toward Recovery

Al wasn’t nervous about the surgery because he had confidence in Dr. McDonnell. However, he was worried about how long the recovery would take. “I was nervous about when I would be able to go back to work and what my range of motion would be,” he says. The recovery process involved walking and began while he was still in the hospital. Patients who undergo spinal laminectomy and fusion procedures are encouraged to walk until they gain enough function to return to their normal activities. Physical therapy is only necessary in cases of continued pain or weakness.

One month after the surgery, Al noticed some weakness in the muscles of his lower back, which is common when recovering from surgery. Dr. McDonnell is monitoring his symptoms to determine whether Al will need physical therapy. Al’s legs, which had been weak prior to surgery, are already becoming stronger now that his spinal nerves have been decompressed. Just eight weeks after the surgery, Al has increased his walking time from a half hour per day to several hour-long walks.

Technology has helped to improve outcomes of complex spine surgeries such as the type Al had. “Over the last 30 years or so, instrumentation with screws and rods has become the gold standard,” says Dr. McDonnell. “These tools enable us to correct patients’ spinal deformities.”

Back on the Road

Although it will likely take three months or more for Al to recover enough flexibility to climb ladders, he is back to work. "I’m able to make [construction] site visits for my business,” says Al. “Every day, I have a little more endurance.” Between the walking and the site visits, he estimates he’s spending up to six hours per day on his feet. Al is looking forward to getting back on the road to attend car shows and races. “Thanks to the surgery, my wife and I are planning an extended trip to the Pittsburgh area for a car show next year,” he says.

When to Seek Help for Back Pain

Everyone experiences back pain occasionally, but how do you know if it’s serious enough to see a physician? Here are some signs to watch for, according to Matthew McDonnell, MD, a spine surgeon at Robert Wood Johnson University Hospital Somerset:

  • Your pain lasts for more than a few weeks and doesn’t respond to over-the-counter pain medications.
  • The pain radiates beyond your back to your arms or legs, or you feel numbness in your back or extremities.
  • The pain is accompanied by weakness in one or more muscle groups.

Learn more about orthopedic services at Robert Wood Johnson University Hospital Somerset. For a physician referral, call 888.724.7123.