Willie Murphy was suffering from crippling sciatica. After a successful prior surgery, Willie decided to return to Massachusetts General Hospital for an evaluation and care. When a radiology consult found damage to Willie’s lower vertebrae, he was referred to Jean Coumans, MD, a neurosurgeon in the Department of Neurosurgery.
"That was the best thing that ever happened to me in all of my 77 years," he says of meeting Dr. Coumans. "I'd give him an apple, an A+ and a gold star." Willie says he would not have wanted to have his surgery anywhere other than Mass General.
Managed by Sciatica Pain
Willie, a Vietnam War veteran, wasn't used to losing control of his body. But his sciatica was excruciating. The pain would come and go, and every time he tried to straighten up like he was taught as a Marine, the pain would pull him back down.
"I didn't like that," he says. "I don't like anything other than me telling my body what to do. It's something I wouldn't wish on my worst enemy."
Sciatica is pain that follows the sciatic nerve, which travels from the lower back, down each leg. It can be caused by a narrowing of the spine called stenosis, or by a breakdown of the discs that act as cushions between the small bones that form the backbone. Risk factors can include age, obesity, occupation and a sedentary lifestyle. Willie, however, had worked at American Airlines for 33 years and was far from sedentary.
Referral to Mass General
Willie previously had carotid surgery at Mass General, where he was once an employee, nearly 50 years ago. He stayed connected with the vascular surgeon who performed this procedure, so he reached out to ask who the surgeon would recommend he see about his spine. After he was referred to Dr. Coumans, Willie knew within 10 minutes that he wanted him to conduct the surgery.
"I'm sitting in his office, and we're chatting, and it feels like I know this man. I'm getting this spiritual vibe that it's going to be okay," he says.
Willie was impressed that Dr. Coumans maintained proper eye contact while they spoke, and that he took the time to answer Willie’s questions and show him exactly where the sciatic nerve was pressing up against the L4 and L5 vertebrae in his spine. These are the lowest vertebrae in the spine and are the most vulnerable to injury because they bear the most weight.
Dr. Coumans says Willie had several levels of wear and tear on his spine, and that he targeted the L4 and L5 vertebrae with a laminotomy, a procedure that partially removes the bony protective covering of the spine (called the lamina). This is often done when the lamina compresses a nerve or the spinal card, which can cause numbness, weakness, or tingling. This made it possible for Willie to avoid having to undergo a more extensive procedure.
"With spine surgery, in general, we are careful to recommend the smallest procedure necessary to improve a patient's quality of life," Dr. Coumans says. "We frequently free up a pinched nerve under the microscope without resorting to an extensive fusion. This requires spending time with the patient preoperatively and examining the patient to really determine the cause of their symptom as specifically as possible."
Getting Back to the Gym
When Willie came out of surgery, he stayed up with one of the nurses and realized that he didn't feel any pain.
"I felt great," he says. "I felt like a new man. In fact, I am a new man."
Everyone on Willie's care team was very professional and took time to explain everything to him so he could easily understand what was going on during his recovery at the hospital.
"I felt like I was at a five-star hotel." he says. "And it wasn't just the service, the people were absolutely awesome."
A self-proclaimed gym freak, it was important to Willie to still be able to work out after his procedure. He initially had to reduce his exercise after the surgery since it would take about six months for his spine to completely heal. However, he has since gotten back up to full speed in the gym and says he is a living example that age is nothing but a number.
Willie says he knows that surgery can be scary, especially when it involves anything with the back or spine. Because of that, it's important for the patient to trust their surgeon. It's also important to do research, ask questions, and to decide for yourself whether a procedure is right for you. In Willie’s case, he says Dr. Coumans will always be a very special person in his life, far beyond the typical doctor–patient relationship.
"He's top of the line, and one of the nicest human beings I've ever met in my life."
Neurosurgical Spine Service
The Neurosurgery Spine Program at Massachusetts General Hospital offers surgical treatment options for the entire spectrum of complex spinal disorders, treating the most challenging cases in the world.