Jessica Rangel – XLIF Minimally Invasive Spinal Surgery

No holding her back

Debilitating back pain is a thing of the past for Jessica Rangel, a former Division I college athlete and marathon runner, after minimally invasive surgery for a herniated disk.

Imagine being afraid to laugh.

That was life as Jessica Rangel knew it two years ago. Division I collegiate volleyball and training for four marathons had scored a herniated disk for the lifelong athlete. Rangel's spine was so sensitive that just a burst of laughter could have her headed to the emergency department and bedridden for days.

"It would hurt to cough, and if I'd sneeze, I'd think, 'Will I throw my back out?'" says the 32-year-old Dallas resident. Once, simply brushing her teeth was the straw that broke the camel's back – or, more accurately, threw out hers.

In December 2008, after epidural steroidal injections had stopped providing pain relief, Rangel realized she could no longer put off spine surgery and scheduled the procedure for three months later.

No better place to be

Because Rangel had served as Methodist Dallas Medical Center's vice president of operations since 2004, she knew well the quality scores of the hospital's James A. Moody, MD, Brain and Spine Institute and trusted its neurosurgical experts.

Richard Meyrat, MD, and James Moody, MD, independently practicing neurosurgeons on the hospital's medical staff, performed the then-new minimally invasive DLIF procedure, also called XLIF, or lateral lumbar interbody fusion.

"What's great about XLIF is that it allows the vertebrae to fuse together naturally," Dr. Meyrat says.

Here's how it works: The surgeon replaces most of the herniated spinal disk with a similarly sized disk made of a metal cage filled with bone graft . This cage lifts the vertebra above it, relieving pressure on nerves and muscle tissue. The surgeon then applies a material called BMP (bone morphogenetic protein), a genetically engineered version of a protein that naturally occurs in the body.

"BMP helps to grow a bridge of bone, called a fusion, that connects the vertebrae surrounding the disk," Dr. Meyrat says. "The result is a well-supported spine."

The two-hour procedure is becoming the new standard of care for people with spinal disk issues. Compared to traditional open surgery, XLIF uses smaller incisions, allows patients to recover more quickly, and usually requires a hospital stay of only two to three days.

Freedom from fear

Rangel says she started experiencing pain relief almost immediately after the surgery. "In terms of care in the hospital and by the different providers, my experience was excellent," she says. "I no longer live in fear of throwing my back out, and I no longer have to be so careful doing normal things."

Sean O'Neal, Rangel's boyfriend of 2½ years, says back problems no longer hold her back. "We live a very active lifestyle, and that includes taking several trips," he says. "Last
fall, we went to the Sangre de Cristo mountain range in Colorado. She went to the high alpine, which is above 14,000 feet. That's intense for someone who's had back surgery."

From the fall 2011 edition of Shine magazine