Marilia Gioia couldn’t do the simplest tasks without severe pain. Walking her beloved dogs had become unbearable. Sitting on the couch to watch TV was nearly impossible. And playing pickleball — something she once loved — was out of the question.

At just 35 years old, chronic and worsening back pain, likely exacerbated by several car accidents, had not only stolen her mobility, but also her marriage, her work and her joy.

“I stopped enjoying life,” the Boynton Beach woman admits. “My husband and I closed our business, my marriage ultimately ended in divorce, and I moved from a townhouse to a home to avoid stairs. The pain drained me.”

Frank Vrionis, M.D., Ph.D.,

For the past few years, Ms. Gioia sought relief from doctors who tried various conservative treatments, but physical therapy sessions, exercise and pain injections provided only minimal or temporary improvement. Her condition continued to deteriorate until her feet became numb and the back pain was so severe that she sought help at the emergency room.

An Innovative Surgical Solution

While several physicians had recommended spinal fusion surgery, Frank Vrionis, M.D., Ph.D., neurosurgeon and chief of surgery at Marcus Neuroscience Institute at Boca Raton Regional Hospital, part of Baptist Health, took a different approach. He proposed an innovative combination approach: a disc replacement at the L4/L5 level in the lower back paired with facet arthroplasty, a breakthrough procedure that replaces the small facet joints located between the vertebrae at the back of the spine.

“Essentially, this is a total joint replacement, a spine replacement,” Dr. Vrionis explains. “It’s similar to a knee or hip replacement. The joints are just much smaller.”

Although not all patients are ideal candidates for joint replacement, for Ms. Gioia it was the best option. “In a fusion, you connect or glue the vertebrae together. Fusions immobilize the spine. In an older patient whose spine may already be relatively stiff, motion may not be as much of an issue, but young patients are better served with motion preservation,” Dr. Vrionis says.

What Are Facet Joints?

Facet joints function similarly to your knee and hip joints, just on a smaller scale. Like those larger joints, they connect bones and enable you to bend and twist while maintaining stability. When the cartilage that cushions your facet joints wear down due to age, injury or arthritis, you may experience a sharp or aching back pain that intensifies when you extend or rotate your spine. You may also notice stiffness and tenderness.

Coupled with her damaged disc, Ms. Gioia’s deteriorating facet joints led to increased neurological symptoms, including pain that traveled down her legs, and tingling and numbness that left her with weakness and foot drop.

During a four-hour surgery in October, Dr. Vrionis first replaced the disc through an abdominal incision. Then, moving Ms. Gioia into a prone position, he made an incision in her back to restore the spinal motion segment and release the compressed nerves.

Life After Surgery

The difference was immediate.

“As soon as I was out of surgery, when I put my feet on the floor, I started crying,” Ms. Gioia says quietly. “I hadn’t realized how much sensitivity I had lost in my legs and my feet. I could actually feel the floor when I walked.”

A month later, Ms. Gioia no longer required the pain medication that she had turned to for years. She is starting physical therapy and is anxious to get back to the pickleball courts. “I’m able to walk my dogs again, stand for longer periods and sit on the couch.”

Dr. Vrionis believes motion preservation surgery will be the future of spine care. “Studies support and show superiority of motion preservation over fusions,” he says. “Fusions often require additional surgeries later because they increase the stress on the segments above and below, increasing failure of the adjacent segments.”

If you have tried non-surgical treatments without success and your doctor recommends spinal fusion, Dr. Vrionis suggests speaking with your doctor to determine if you might be a candidate for motion preservation surgery.

For Ms. Gioia, the emotional recovery has been as dramatic as the physical journey. “I feel happier. I am still recovering, but I’m going to be 100 percent soon. I feel like I have regained my life.”