When the surgeon saw the MRI of my back, he was surprised I could walk

When Nadia Bosch went to the GP because her back was sore, she thought she would get painkillers. She certainly wasn’t expecting emergency spinal surgery. 

One Saturday, at the end of February, 34-year-old mom of three Nadia Bosch woke up in terrible pain. “My back was totally locked up and I couldn’t even stand,” she recalls. Nadia’s husband took her to the GP, who gave her an injection to ease the pain – but he was concerned. He advised that Nadia be admitted to hospital and go into traction. However, the nearest hospital had no beds available at the time. So, no longer in pain and not imagining her condition might be serious, Nadia spent the afternoon at a kiddies’ party with her daughter. “I remember, I was eating cake and the hospital called to say I could come in and I thought, ‘ag, I’ll call them later’,” she admits. “I feel a bit bad about that now.”

Finally admitted and in traction, Nadia’s back was feeling good, but she started losing feeling in her left calf. Preliminary tests and examinations revealed her leg was also losing strength, prompting the orthopaedic surgeon to call for an MRI scan. The catch: Nadia lives in the small Western Cape town of Oudtshoorn, so it meant spending the weekend in hospital and then travelling to Mediclinic George to have the MRI. By the time the scan had been conducted, Nadia’s leg strength had decreased even more, and her orthopaedic surgeon referred her to neurosurgeon Dr Derek Ackermann. “He came rushing to my bedside,” Nadia recalls, “and he said, ‘They said you walked to your bed?’ Let’s go down the hall to see your MRI scan – I want to see you walk.’” Nadia did as instructed, thinking it was standard procedure. “But as I walked, he was looking at me very weirdly,” she recalls. When she saw the scan, she understood why.

“Nadia had a large disc sequestration between two vertebrae in her back. It was massive,” Dr Ackermann says. He explains that spinal discs consist of a tough outer layer and a soft inner layer. When the inner layer pushes through a crack in the outer layer and puts pressure on the nerves in the area, this is called a disc sequestration. “Usually people wouldn’t be able to walk from the pain and would have neurological deficit as well. That’s why I was surprised.” 

Nadia was scheduled for urgent surgery because, if left too long, a disc sequestration can cause permanent damage – including loss of bladder function and even paralysis. “We performed a microdiscectomy – it’s a fairly routine procedure where we remove the bulging disc to take pressure off the nerves,” explains Dr Ackermann. “It takes about 45 minutes to an hour.”   

“Everything went very smoothly, even though Dr Ackermann said it was one of the biggest [sequestrated] discs he’s ever removed,” says Nadia. “I was in no pain at all afterwards. And Mediclinic George was like a five-star hotel. Everyone was so nice! They explained everything so well. The food was amazing.” 

For seven weeks, Nadia had to be very careful, not picking her kids up and training herself not to sleep on her tummy. Three months on, she still has slight numbness in her left calf, but her strength is improving steadily and her life is mostly back to normal. However, she will need to maintain strong core muscles and avoid lifting heavy objects from now on. “The surgery itself won’t affect her spine, but there are existing degenerative changes in her spine and they stay there,” explains Dr Ackermann. It means her horse-riding days are over – Nadia has ridden for most of her life and had several falls, likely contributing to the back issues. She’ll also need to avoid running and other high-impact sports. But low-impact exercise, like cycling, swimming and hiking, is fine. 

Back pain is not uncommon, but Dr Ackermann says there are signs to look out for that could indicate something more serious. “If the pain radiates down one or both legs, if one leg feels weaker than the other or if you have bladder symptoms accompanying the back pain, you should get it checked out as soon as possible,” he says. “Also, if you have back pain that’s accompanied by fever or weight loss or if you have a cancer history – it is possible to have infections or cancer that spreads to the back.”