Cheryll S Back to Active

“My experience—from the first time I met a doctor to my follow-up visits—was extremely positive.”

At late middle age, former gymnast Cheryll still thrives on physical challenges. In addition to working out daily, she stays energized running her small business, maintaining her home and pursuing physical hobbies, which keep her constantly active and on the move.

But by 2017, years of bodily wear and tear had taken a toll on her spine, and the athletic mother of two adult children was experiencing chronic pain.

“I tried to work through the pain by strengthening my muscles,” she says. “I would work out and still be in pain afterwards, and it just got worse, to the point where I would take ibuprofen and spend hours lying down.”

An MRI (magnetic resonance imaging) scan confirmed that severe damage had developed in Cheryll’s neck and lower back. She had surgery to fuse disks in her neck, but the procedure didn’t completely ease her pain.

As a result, she hesitated to take the same step for the severe pain in her back. “I was apprehensive about having it fused, so I pushed surgery to the last possible minute,” Cheryll says. “I lived with the back pain until I couldn’t.”

Deciding on Surgery

Cheryll carefully researched surgeons to determine who might undertake the procedure this time. Her legwork led her to Marc J. Levine, MD, Director of the Orthopedic Spine Surgery Program at Robert Wood Johnson University Hospital (RWJUH) Hamilton and a member of RWJBarnabas Health Medical Group. Dr. Levine specializes in minimally invasive spine surgery, and RWJUH Hamilton has received certification for spine surgery from The Joint Commission, a leading accrediting organization.

Dr. Levine diagnosed Cheryll with spondylolysis, a defect in the bony structure of one of her vertebrae (stacked bones that make up the spinal column). Spondylolysis is usually due to a developmental abnormality or a result of repetitive stress and overuse often seen in athletes, particularly gymnasts.

“Once you have this bony defect, you can start to develop a deformity in which one block of bone slides over a neighboring block—a condition called spondylolisthesis,” says Dr. Levine. The related conditions often occur together.

“We first give people a chance to improve with nonoperative treatment such as physical therapy and pain management,” Dr. Levine says. “But when those things stop working, surgery makes sense.”

Surgery certainly now made sense to Cheryll. She was eager to ease her pain, return to the gym and engage in many of her other favorite physical activities. Confident in her new surgical team, she agreed to go ahead with another operation.

A Twin Procedure

In May 2024, Dr. Levine treated Cheryll’s pain by essentially performing two surgeries in a single procedure.

The first, called an anterior lumbar interbody fusion (ALIF), approaches the spinal column through an incision in the abdomen. “By going through the belly, you avoid disrupting back muscles,” Dr. Levine says. This front-of-body approach makes healing easier and less painful.

ALIF benefits from partnership with a vascular surgeon. “To approach the spine from the front, you need to carefully move contents of the abdomen, such as organs and blood vessels that sit in front of the spine, to one side and out of the way,” says Saum Rahimi, MD, a vascular surgeon at RWJUH in New Brunswick, RWJUH Hamilton and Robert Wood Johnson Medical School, and a member of RWJBarnabas Health Medical Group. “This creates a safe space for the spine surgeon to operate.”

Once Cheryll’s spine was exposed, Dr. Rahimi used a device called a retractor to hold the abdominal organs and blood vessels in place. Dr. Levine then removed the disk material between the affected vertebrae and replaced the disk with a spacer, or interbody device, which is filled with bone graft material to help fuse the vertebrae together.

After the ALIF procedure, Cheryll was turned over for a posterior spinal fusion—a minimally invasive procedure that’s done through the back. With the help of X-ray guidance, Dr. Levine inserted four screws through small incisions in the skin and attached them to rods on each side of the spine to support it, with little disruption of muscle.

These interdisciplinary procedures together create a framework that provides stability in both the front and back of the spine. “The interbody device in front provides stability with flexion [bending forward], while putting screws and rods in the back adds to extension stability and support,” Dr. Levine says. “It’s a very stable construct with 360 degrees of support, and outcomes are very favorable in patients with abnormalities like Cheryll’s.”

Collaborative Experts

Drawing on a collaborative network of experts is among the pluses of having procedures performed at RWJBarnabas Health, says Dr. Levine.

“Having all the resources a patient needs within one health care system means we can coordinate care from start to finish, including steps such as preoperative exams, postoperative physical therapy and MRI and CT [computed tomography] scans,” he says. “Patients benefit because we’re able to work together as a team.”

With her pain relieved, Cheryll concurs. “The hospital was phenomenal, and the team made it that way,” she says. “My experience—from the first time I met a doctor to my follow-up visits—was extremely positive.”

Three months after surgery, Cheryll got the go-ahead to remove the back brace she had needed while healing—an important step toward restoring her active life. “I couldn’t wait to get back to the gym,” she says.

Learn more about spine surgery at RWJBarnabas Health.