"I Felt Like I Was His Only Patient"

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Joan Lazarou with her pet dog

The first time Joan Lazarou, 60, felt an odd tingling sensation in her feet she figured it was due to the cold January weather and just put on an extra pair of socks. But over the next few weeks the tingling got worse, and soon it was accompanied by periods of numbness as well as shooting pain down her legs, especially at night after she lay down to sleep. By March Joan was having difficulty walking.  “I would have to sit down all of a sudden because the numbness in my feet would come out of nowhere,” she recalls.

Joan wondered if her symptoms had something to do with the hip replacement surgery she’d had months earlier, or the knee problems she was having due to years of running (including 26 marathons).  But her doctor ruled both of those out. Desperate for help, she went to see a neurologist, who suggested physical therapy and over-the-counter pain medication, but the numbness continued. A visit to a second neurologist proved fruitless too. “No one could figure out what was wrong with me,” says Joan.

Meanwhile, her symptoms worsened. Unable to stand for long periods of time, daily tasks like cooking and doing dishes became difficult. Joan took baths instead of showers, and parked her car as close to store entrances as possible when she had to run errands.  “I would lean on a shopping cart for support,” she recalls. “But even then I would have to sit down periodically and rest until the feeling in my feet and legs came back.”

Joan started needing rides to work — she was the administrative assistant to the Dean of Admissions at the nearby Albert Einstein College of Medicine in the Bronx — because she couldn’t walk to and from her car. “A co-worker would have to pick me up at home and drop me off in front of our office building,” she recalls. And she spent more and more time at home. “I could no longer do the things I enjoyed like walking my dog, going to museums, meeting friends for dinner. It was impossible to stand on long lines. I blamed it on my knees, my hip — I blamed it on everything.”

After seeing a third neurologist, who referred her to a vascular specialist, Joan finally started getting answers. The problem was not her hips or knees at all, but in her spine. At first Joan didn’t believe it. “I had never had back problems before,” she says. “I never had any pain in my back – never.

But an MRI confirmed that Joan was suffering from spinal stenosis in her lower back – a condition in which a narrowing of the spinal column puts pressure on the nerves, causing pain and numbness. She needed to have surgery right away. Without it, the nerves could become permanently damaged, leaving her at risk for bladder and bowel incontinence, sexual dysfunction, and even paralysis.

Joan had already had two shoulder operations, and her hip replacement had been extremely painful with a long and difficult recovery, so she was terrified of having surgery again, especially on her spine. That’s when her brother-in-law, who is a doctor, suggested she see Dr. Eric Elowitz, a neurological surgeon at the Weill Cornell Medicine Brain and Spine Center. “He said that I needed the best doctor to operate on me,” she says. Joan did a little research, which confirmed what her brother-in-law had told her.

Dr. Elowitz immediately put Joan’s mind at ease. “When I met Dr. Elowitz everything changed,” she says. “He has a kind smile and a very calm demeanor. I felt like I was his only patient. He took the time to listen to me and answer all my questions.”

Dr. Elowitz explained that he used a minimally invasive surgical technique called a lumbar fusion to repair spinal stenosis. The procedure takes the pressure off nerves by fusing the affected vertebrae together, keeping them in the correct position using small rods and screws. Because the incision is so small, blood loss and pain are greatly reduced, and the recovery time is much shorter than traditional open surgery.

Even better, Dr. Elowitz was pioneering an advanced version of lumbar fusion surgery, using a computerized navigation system and new cortical bone trajectory screws that are stronger than others and require a smaller incision. Joan would be up and walking the same day, he assured her, and be home a day or two later. It would be nothing like her hip replacement. Relieved, Joan agreed to have the surgery a few days later.

The operation was a success. Waking up afterward, Joan waited anxiously for the anesthesia to wear off and the pain to kick in. But it never did. “I never had pain -- ever!” she says. Not only that, but the numbness and tingling were gone, and by the evening she was walking on her own, just as Dr. Elowitz had told her. “I walked to the bathroom that night. And the next day I walked up and down the hallway of the hospital all on my own.”

Joan walked out of the hospital and to her car without help. “Once I was home, I began walking one hour a day, eventually working up to one to two miles a day,” she says. “That was my physical therapy. I didn’t have a problem doing anything.”

Dr. Elowitz and Dr. Hussain, who authored a paper on a pioneering surgical technique that advances the field of minimally invasive spine surgery.Dr. Elowitz (right) with Dr. Hussain (left), who authored a paper on a pioneering surgical technique that advances the field of minimally invasive spine surgery.

More than two years later Joan is happily retired and enjoys walking her dog, riding her bike around the neighborhood, and seeing friends. And Dr. Elowitz and his team recently published a paper in World Neurosurgery documenting the pioneering technique he used on Joan, called PLIF-CBT (for posterior lumbar interbody fusion with cortical bone trajectory screws). Weill Cornell Medicine and NewYork-Presbyterian remain one of the only facilities in the metropolitan area that performs this minimally invasive fusion procedure.

Joan still marvels at how good she feels, and she credits Dr. Elowitz and his colleagues for giving her back her life. “My life before surgery was terrible,” she recalls. “Now I’m able to go anywhere without worrying how long I can stand. I am so thankful for Dr. Elowitz. He’s a great doctor. You sit down with him and you feel like you’ve known him forever. He makes you feel very comfortable and he takes away any anxiety or fear that you have. I would tell anyone who is considering spine surgery with him not to be afraid. You’ll be in excellent hands.”

More about Dr. Elowitz

More about the PLIF-CBT procedure

Read the abstract in the February 2018 issue of World Neurosurgery