A Former IBM Exec Uses Ingenuity to Survive Spinal Stenosis, Spondylolistheis AND Scoliosis.

Mr. Yogendra (Yogi) Singh, now a 75-year-old retired IBM information technology executive had been suffering from a debilitating combination of spinal issues. His primary problem was a grade-1 L4-5 spondylolisthesis (also known as a slipped disc or vertebra) which was causing severe narrowing of the spinal canal (spinal stenosis). However, he was also suffering from degenerative scoliosis, a condition where the vertebrae become malaligned from disc disease. Spondylolisthesis in isolation can easily be treated with a single level spinal fusion or decompression, however the treatment for the scoliosis requires a much larger multi-level spinal fusion surgery. Performing a single level fusion in the presence of scoliosis can also be risky as the fusion can exacerbate the scoliosis deformity. Hence the conundrum: do you do a relatively small spinal operation or a large one with greater risk?

We had several discussions about how to best treat his disease. I was concerned about doing a large surgery on him because of an increased risk of complications and ultimately, I felt it was unnecessary due to the stable nature of his scoliosis. Furthermore, his problem occurred during the height of the COVID pandemic in New York and so a lengthy hospitalization would be risky. Together we decided that the best course of action was to treat the spinal stenosis and the slipped disc alone considering his scoliosis was mild and not as bothersome to him. We fused L4-5 and did a decompression as well. His scoliosis has remained stable since the operation.

His recovery has been remarkable now two years from his surgery, but it was not completely due to my work. After the procedure, Mr. Yogi, an ingenious person, devised his own rehab routine during the COVID pandemic where he created a walking track in his house that involved stairs and measured distances. As he notes, he was able to walk significant distances without ever setting foot outside during the pandemic. Most people would likely have used the pandemic as an excuse not to do rehab. In addition to this, his surgical course was not totally smooth, and he suffered from delayed wound healing which required a revision of his scar by a plastic surgery colleague of mine. Ultimately, he went on to heal without incident, but he dealt with the problem in a methodical fashion, never complaining, only wanting to know how to move forward. These characteristics showcase his grit and resolution to heal which I believe dramatically improved his outcome.

His case highlights several important concepts in spine surgery and recovery:

-Sometimes a smaller surgery can be all that is necessary to treat a spinal problem. A careful discussion with your surgeon about symptoms and goals surmounts any amount of testing or imaging.

-Mental state is critical for recovery and you must be creative and resourceful to overcome limitations after spine surgery. 

Here is his story in his own words:

“By early 2020 my lower back problem had become quite severe. After standing for over 5 minutes, or walking about 200 feet, I needed to sit down for at least a few minutes to rest my back. This had a major impact on my quality of life, and surgery to treat my condition was necessary. I met Dr. Katsuura, who was then at HSS, to discuss the spinal surgery, potential outcomes, and risks involved. The diagnosis of spinal stenosis, degeneration of lumbar disks, and degenerative scoliosis required complex spinal surgery. Due to COVID we had to wait until June 2020 to schedule my surgery, which was performed by Dr. Katsuura, and the procedure included decompression at L2/L3 & L4/L5 levels, as well as fusion & instrumentation of L4/L5 vertebrae. It was a complex surgery, but the results were beyond my most optimistic expectations.

I was advised to walk as much as I could tolerate, as the preferred physical activity. Using a gym was not advisable due to COVID, and the repetitive motion involved on the treadmill we have at home required a different solution. To avoid the heat of summer, and to maintain a comfortable and safe walking environment, I created a path within my house that spanned the entire living space and measured the distance walked per round. Within 3 weeks of my discharge from the hospital I was walking 1/2 mile at a time with the help of a walker for safety, four times a day, for a total of 2 miles. I was able to increase it to 3 miles at a time, twice a day for a total of 6 miles per day, within 6 weeks after my surgery. I am currently maintaining my 6 miles of walking per day, in addition to other normal activities including running after my granddaughter who will be 3 years old soon, vacations on the beach, and multiple road trips. I also made two trips to India in Spring 2022 which involved 15-hour flights each way.”