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Anne Arundel Medical Center

AAMC Magazine

Winter 2010

Extreme Procedure, Extreme Success

New Minimally Invasive XLIF® Operation Provides Relief for Back Pain

Alessandro Speciale,M.D., William VIta, Brian Sullivan, M.D.

Orthopedic surgeon Alessandro Speciale, M.D. (L), with assistance from neurosurgeon Brian Sullivan, M.D., (R), gave back patient William Vita relief from debilitating pain caused by degenerative disc disease.

Annapolis resident William Vita was ready to try anything to relieve the stabbing pain radiating down his right thigh by the time he was referred to spine surgeon Alessandro Speciale, M.D., in November 2008. No stranger to back surgeries for spinal stenosis, scar tissue and bone spurs, the 79-year-old retired fundraiser said despite four recent nerve root blocks, pain had rendered him nearly immobile.

“It was hard to do anything,” recalled Mr. Vita.

Aware of Mr. Vita’s past back surgeries and current degenerative disc location, Dr. Speciale recommended a relatively new procedure to relieve the pain called XLIF, or eXtreme Lateral Interbody Fusion.

The minimally invasive approach allows surgeons to access the spine through very small incisions on a patient’s side. Using guided X-ray, physicians remove damaged disc material and insert an implant through the same incision. This high density spacer—also called a cage—is filled with bone graft material and holds the vertebrae in the proper position, therefore allowing the spine to fuse. In addition to less cutting and smaller incisions, the XLIF® procedure also minimizes blood loss, decreases tissue and muscle damage, and aids in overall recovery time.

Mr. Vita’s primary back doctor, neurosurgeon Brian Sullivan, M.D., agreed with the surgical recommendation and joined Dr. Speciale in the operating room to insert four cages into Mr. Vita’s spine, the most either doctor had ever inserted in a single operation. In addition, they also inserted screws through several small incisions in the back and tunneled two rods under the skin to help straighten the curvature of Mr. Vita’s spine due to scoliosis. The 10-hour procedure was a huge success.

I want to thank you with all my heart for giving my Dad back to me. After his first visit with you, I heard hope in his voice for the first time in a long time.
             – Excerpt from a letter written by William Vita’s daughter, Theresa Vita

“I had almost instant relief,” Mr. Vita recalled. “I had no pain in my thigh. My wife and I knew it was a risky procedure and I was scared, but I couldn’t be happier.”

The procedure was so successful, Mr. Vita added, that he was completely off pain medication before he left the hospital and was able to recuperate entirely at home, aided by his wife, Dolores, who served as his dedicated caregiver.

“My back has never felt better,” Mr. Vita said, who now exercises by walking in a pool almost every day, something he was unable to do before the XLIF surgery. “These doctors really deserve so much credit. I am very grateful to them,” he said.

“This really changed his life,” Dr. Speciale said. “My hope is that this is the last operation he will ever need.”

--Jenny Steffens

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