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An assignment in Iraq is fraught with danger. But it wasn't the fear of a roadside bomb or incoming mortars that interfered with Gavin Helf's work. He shook at the prospect of strapping on his personal protection equipment. Donning his flak jacket and helmet every time he traveled outside the Green Zone was excruciating.
"The back paid I'd suffered for years would flare up under the heavy load of protective equipment," Gavin remembers.
As a diplomat with the U.S. Agency for International Development, Gavin has traveled all over the world and spent long agonizing hours in pain while sitting on airplanes. Standing for extended periods was painful as well. For Gavin, this wasn't anything new. His memories of childhood, adolescence and adulthood are peppered with bouts of debilitating back pain. "It was always a part of my life," he recalls.
In 2012, he was fed up.
"I was getting old and crooked! I could change 'old' but I could do something about 'crooked,'" he says.
Minimal Surgery, Big Relief
That March, Gavin sought assistance from MedStar Georgetown Orthopaedist and Spine Expert Seyed Babak "Bobby" Kalantar, MD .
"An MRI showed a severe collapse of a disc in his lower back between the L3 and L4 vertebrae," Dr. Kalantar explains. "The degeneration of that disc had caused his spine to curve. Bone was pressing on nerves causing severe pain."
"Dr. Kalantar explained all of my treatment options," Gavins says. "I had been afraid of surgery because I'd heard horror stories about it. But Dr. Kalantar told me I was a candidate for a minimally invasive procedure. So I scheduled surgery for the day before my 50th birthday."
"I always look for the least invasive treatment alternative for patiens," Dr. Kalantar says. "Many patients will have good results with medication, physical therapy or injections to reduce inflammation. But Mr. Helf's pain was really limiting his life, and he was a good candidate for a spinal fusion procedure called XLIF, or eXtreme Lateral Interbody Fusion."
Rather than cut through all the muscles in the back to get to the spine, in this procedure surgeons make a small 2-inc incisions at the patient's side. "And we make small 'poke holes' in the back for the surgical instruments to reach the treatments site. Using a real-time image as a guide, we place a small synthetic cage at the location of the degenerated disc," Dr. Kalantar says.
"It serves as a kind of scaffold that will hold new bone that body produces over time. Because we're fusing the spine at a single area, patients don't have mobility problems after surgery. In fact, many patients, like Mr. Gaving, move normally for the first time in years."
A Birthday Wish Granted
Gavin sailed through surgery and was discharged the next day. "I was pretty determined to celebrate my birthday at home," he says. "I had to accomplish three things: sit up, walk up stairs and go to the bathroom. It hurt to get up at first, but when I did, I felt oddly different. I felt taller!"
At home, Gavin stood at the wall marked with family members' heights through the years. He was a full centimeter taller.
Now Gavin says he is positively evangelical about the procedure, telling anyone he knows who has persistent back pain to go to MedStar Georgetown. "Dr. Kalantar was fantastic, and the care at the hospital was great. And at my six-month checkup, for the first time in my life my spine looked absolutely normal."
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