Dear colleagues and students,
I wanted to let you all know that I have decided to have further spinal surgery. It will take place on Wednesday, April 5, at Rush University Hospital in Chicago. We got a second opinion at Northwestern, but decided on Rush in the end. I don't know the time as yet, but when I do I will let you know. Prayers will be appreciated.I have been pursuing non-surgical options vigorously for several months, including chiropractic and vigorous physical therapy under the supervision of a physiatrist at Rehabilitation Institute of Chicago, where I also got a spinal steroid shot. That helped a lot, but I can already feel it wearing off and the pain and disability returning.
The previous surgery was successful for a time, as the laminectomy freed up the nerves. But in 15 % of all cases after such surgery, the band that holds the spine together is weakened. What can result is a spyndlothesis (don't hold me to the spelling on any of these medical terms) which is one vertebra slipping out of line with another. This pinches the nerves all over again, and there is no non-surgical treatment to get it back where it belongs and make it stay there. It is clear from the MRI's that I have this condition now and did not have it before the previous surgery. It is possible this explains the difficult recovery I have experienced from the first surgery.
There does not appear to be any non-surgical treatment for this condition. After Christmas I had some significant further damage to the nerves in my left quad, which means that leg is much weaker and buckles on occasion again, as it did earlier in my first recovery. My fear is that if I do not have this surgery, or delay it, I could have a similar problem with the right leg as well as lose the opportunity to have some recovery in the left.I have chosen to have the surgery here where there are three neurosurgery programs in the top 50, with Rush the best in the area (U o Chicago and Northwestern are the others). I also have a great rehab/physical therapy team, though that dimension will continue in Sewanee. I also wanted to leave enough time to make it almost certain that I will be back at work in August, and should be able to travel in time to teach summer school (take note, Don) if there are no serious complications.
My hope is to be better than I have been since six weeks post the first surgery. But keep the scooter charged up, just in case.The saddest part of this for me is that we will not be able to return to Sewanee for commencement and bid farewell to our friends in the class of 2006. I deeply regret that, and will be thinking of you on your big day. May God bless all your ministries, and I hope to see many of you soon when you return to the mountain....
Things will be much quieter for a while, obviously.I have saved the details of the medical procedure for last so that those for whom this is TMI can stop here.To quote my neurosurgeon:"1. I think most of your problems now are arising at L4-5 and there is a definite progression in the slippage at L4-5 from the pre-surgery MRI. I am concerned that you didn't improve much after the first surgery initially and therefore would like to increase the scope of the surgery to include L3-42. The disk at L4-5 will be removed and a plastic piece placed to facilitate a fusion at L4-5. This would be an interbody fusion. The rates of fusion with only posterior fusion are lower than interbody fusion rates. Additionally the interbody instrumentation will help prevent further slippage. Biomechanically, most of the force in the lumbar spine is transmitted through the interbody space.3. There is still residual stenosis especially above the previous laminectomy at L4-5."So, he will do an interbody fusion at L 3-4-5, and clean out any other foramina that seem to be causing stenosis. With luck, that will eliminate most of the leg pain, prevent further damage to the leg nerves, and allow for the possibility that I might gain some back in the left leg.We will be keeping you posted, and please keep the prayers coming.
Love to all,Bob and BarbaraThe Rev. Robert D. Hughes, III. Ph.D.
Norma and Olan Mills Professor of DivinityProfessor of Systematic Theology
School of TheologySewanee: The University of the South
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