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Spondylolisthesis, Spinal Surgery

Joseph back pain spine patient on boat with wife

“I’ve had back pain for forever and half a day,” Joseph Frompovich says.

He’s exaggerating, of course, but not by much. Joseph’s back started bothering him right after a fall while he was in the Air Force. He was in his early twenties at the time. He’s 73 today.

“The pain always got my attention,” he says. “It’d knock me down for a few days, but then I’d be back to normal.”

He worked his way up from toolmaker to manufacturing engineer. The promotion meant lots of long hours on his feet, most of them on unrelenting concrete floors. Outside of the shop, Joseph didn’t slow down any. He and his father built the house he lives in today. And he was—and remains in retirement—an avid sportsman. But, reflecting on his life, it’s defined by long stretches of mild discomfort punctuated by brief bouts of debilitating pain.

He received a course of steroid injections in the 1990s, which helped to an extent. But each time his back flared up, the pain grew progressively worse. Joseph wasn’t helping his cause, either. With a promotion to senior engineer in 2000, he pushed his body even harder, working longer hours and traveling almost constantly.

On a handful of occasions, when the pain became unbearable, Joseph would read up on surgeries that could potentially help him, but he always talked himself out of looking into them any further.

“Everything scared me,” he says. “It’s playing with the horse hairs on my back, if you know what I mean. There’s always the possibility that I may not be able to walk again, which is really scary to me because I like being outside and doing lots of things.”

The tipping point (sort of)

Joe fishing on boat, spine patientAbout four years ago, Joseph’s back “got really cranky,” as he likes to say. This time around, he was having a hard time hunting and fishing, and the pain wasn’t subsiding. Still, it took seeing his wife injure her back to begin to believe in the benefits of treatment. Almost as soon as she received an injection, she was back to her normal self.

Joseph continued to watch her for the next month. When she didn’t regress, he scheduled an appointment for himself. The physician sent him to get an MRI first. When Joseph returned, the physician said an injection wouldn’t help him. He needed to see a spine surgeon.

But again, Joseph resisted. Instead, he began getting steroid injections from a pain management doctor, which Joseph, a type 2 diabetic, says did little but “jack up my blood sugar.” On the verge of trying another minimally invasive treatment, Joseph’s neighbor, a Penn Medicine cardiologist, intervened and scheduled an appointment for him with her colleague, Harvey E. Smith, MD, associate professor of orthopaedic surgery at the Perelman School of Medicine at the University of Pennsylvania.

“It was sort of a classic presentation of chronic, progressive, degenerative disease that slowly eroded his quality of life,” Dr. Smith says. “In the beginning, Joseph was able to make do and live with it. And then it got to a point that it was significantly limiting his quality of life, and he was miserable. “That’s usually what will happen,” he says. “Many people will live with chronic pain up to a point and then it starts robbing too much from you in terms of your daily function. That’s when most seek out surgery.”

Through surgery, Dr. Smith was able to relieve the severe compression of nerves in Joseph’s back and stabilize an area of his spine that had become mechanically unstable as a result of a condition called spondylolisthesis.

It’s a new day

Around 6 a.m. the next morning, a nurse came into Joseph’s room and asked if he could get out of bed on his own. Within the hour, he had walked a couple laps around the corridor.

“I could feel the incision from the surgery, but the pain from my spine was gone. It was like a big black hole now,” Joseph says.

As his incentive during recovery, Joseph bought an almost-20-year-old boat. Three months after surgery, he got to work tearing it apart so he could rebuild it. “It’s a lot of activity. I’m constantly up and down,” Joseph says. “And I’m rolling underneath of it when most of my friends can’t even bend over.”

The boat’s done now. Joseph’s deciding whether to sell it or not; he has two others. But he’s just starting to come into his own. Within the last few weeks alone, he’d cleaned up a couple of trees that had blown over in his backyard, installed a new dryer, and replaced their water heater.

“I feel 30 years younger now,” he says. “My wife says 40.”

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