At the Bedside: Woman with ‘flatback syndrome’ able to stand tall, enjoy life again after 14-hour spinal surgery

Michigan native Ruth Bischoff, 69, had tried everything – multiple spine surgeries, a radiofrequency ablation, acupuncture, a spinal cord stimulator, and more – but she couldn’t find any relief from the shooting pain in her lower back that prevented her from standing up straight and walking. A pain pump offered some relief, but Ruth ultimately turned to high doses of opiates, including morphine and hydrocodone, to temporarily ease the debilitating pain.

By the time she moved to Texas in 2020, Ruth had developed flatback syndrome – a condition frequently occurring after failed spinal fusion procedures that causes an unnatural flattening of the lower spine, which can lead to significant pain, impaired posture, and gait impairments.

Her daughter urged her to see a doctor, and she was referred to John C. Quinn, MD, an assistant professor in the Vivian L. Smith Department of Neurosurgery with McGovern Medical School at UTHealth Houston who sees patients at UTHealth Houston Neurosciences Spine Center.

Quinn immediately ordered a standing X-ray of Ruth’s entire spine, as well as a full CT scan on her back. The tests and scans showed the complete loss of curvature in her lumbar spine, due to her previous spinal fusions, a severe degree of spinal malalignment when attempting to stand up straight, and new disc degeneration above her fusion. Quinn realized that surgery to treat the new problems above her fusion would require extending her fusion into her thoracic spine and cutting a wedge of bone through her prior fusion to restore normal spine curvature and “rebalance” Ruth’s spine. In February 2021, Quinn performed a 14-hour spinal fusion surgery on Ruth at Memorial Hermann-Texas Medical Center.

Since the procedure, Ruth has stopped taking hydrocodone altogether and has significantly weaned off the morphine. She’s now able to exercise in her pool and garden daily, and has lost 40 pounds.

“I was always going for the fix, and it never happened, so I just thought I was going to throw in the towel, accept the pain pump, and live on opiates the rest of my life,” Ruth said. “I hope that someone like me who has searched and searched for so many years can find a person like Dr. Quinn, who can actually deal with the root of the issues.”

At the Bedside is a series of patient stories with UTHealth Houston physicians and staff.