Spinal Fusion Surgery Gives Manchester Veteran Pain Relief, New Lease On Life

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It wasn’t an easy decision because he was not confident it would give him the relief he was desperate to find. His father had suffered a back injury years earlier after being attacked while he was working as a train conductor and had sought surgery.

“It turned into 12 or 13 surgeries,” Daley said. “It snowballed. For years I watched him go through all those surgeries and pain.”

The pain Daley had suffered for years had gotten so bad, however, that he decided to look into surgery, and on April 22, he had anterior lumbar interbody fusion surgery at Community Medical Center in Toms River. The surgery was performed by Dr. Sean Jandhyala, an orthopedic surgeon in the Community Medical Center and RWJBarnabas Health Medical Group.

It has changed his life for the better, Daley said.

“Day one in my back and my leg it (the pain) was completely gone,” he said. “There were no shooting pains, nothing.”

The IED blast

Daley says it was a twist of fate that he was not more seriously injured in the IED blast in Afghanistan nearly 15 years ago.

Daley, who was a U.S. Army staff sergeant, was in a group that was searching Afghan villages in 2010 for terrorists when the vehicle he was driving — a MAT-V, which he described as a glorified beach buggy that was reinforced to protect it — rolled over an improvised explosive device.

The 3-ton blast blew the front of the vehicle off, Daley said, jolting everyone inside and leaving Daley’s legs exposed. The jolt damaged disks in the lumbar part of Daley’s back. Other soldiers in the unit were injured as well.

Daley didn’t normally do the driving, he said, but on this particular day he wanted to get behind the wheel.

“The MAT-V was fast,” he said. “You could drive across the desert at 80 mph,” which made it fun.

Deciding to drive likely saved his life, he said, because had Daley been seated where he normally sat, it’s likely the blast would have killed him. A soldier sitting next to Daley’s usual seat was hit in the ankle “and it destroyed his ankle,” Daley said.

When Daley and his soldiers were rescued after the explosion, there was shock from other soldiers. “How are you guys even alive?” Daley said they were asked. The blast created a hole large enough for the entire MAT-V to go into.

“It should have killed us,” Daley said. Several soldiers were injured, and some ended up returning to the U.S. as a result. Daley did not. He finished out his tour in Afghanistan, about 4 or 5 more months. He didn’t feel the pain in his back pain much at the time.

“You’re in a constant state of war,” he said. “With the adrenalin going on you don’t really notice (the pain).”

Once he was back in the U.S., Daley served for about three more years, before the Army made him retire. By then, the pain was a constant companion. He would get nerve-blocking shots, but they would only last about three months before the pain became unbearable again.

He found another doctor, and that doctor was able to find a “sweet spot” where Daley was getting six months of relief from the shots. That lasted for a while, but then he was back to every three months.

As Daley was coping with the pain, he also was trying to raise his children. For a time he was raising them by himself, then later under shared custody he would pack as much into the weekends as he could.

“When they were little we went outside. We would run around, throw balls,” Daley said, but over time that became just too painful and difficult.

Choosing surgery

When Daley could no longer get extended relief from shots and changing positions didn’t bring relief, he started to research his options and found Jandhyala.

“We went through everything in detail,” Daley said. Jandhyala had magnetic resonance imaging testing done on Daley’s back.

It showed a slip in one of Daley’s vertebra in his lower back that was pinching nerves.

Jandhyala, who has been practicing for five years and has been working in the industry for 14 years, said the MRI findings matched the symptoms Daley was having, and showed that if they were able to surgically repair the problem it would likely improve Daley’s quality of llfe.

Because Daley was young and in good health, it made him a good candidate for the surgery, which was tricky.

In anterior lumbar interbody fusion and decompression surgery, the doctors go into the body through the front all the way to the spine. A vascular surgeon assists, moving the patient’s organs out of the way and protecting all the important blood vessels.

“It’s a team effort,” Jandhyala said. Dr. Issam Koleilat was the vascular surgeon who assisted — “He’s very technically gifted,” Jandhyala said — and Community has a dedicated orthopedic floor with nurses and physical therapists whose responsibility is orthopedic patients.

“I’m fortunate to have the best spine team in New Jersey,” Jandhyala said.

Once the major blood vessels were protected and the organs were out of the way, Jandhyala said he removed the diseased disc in Daley’s spine and put in a big metal spacer and cage to stabilize his spine. With that part of the surgery completed, they closed his incision and turned him over on his stomach.

From the back, they removed everything that was pinching Daley’s nerves and then put screws in his back to hold the cage and spacer in place, Jandhyala said.

The surgery takes four to five hours, he said. Afterward, most patients feel immediate relief from the pain that had been caused by the pinched nerves.

Daley said he was left with a 3-inch scar on his abdomen, similar to a Caesarean section scar. He had some pain in his abdomen during the initial recovery but it was minimal.

The relief from the back pain was immeasurable, Daley said, noting that he had been dealing with it for so long that it was almost a shock how differently he felt afterward.

It’s improved every aspect of his life, Daley said.

He and his wife, Crystal, are able to go for walks on nice days, something they were not able to do much during the first five-plus years of their marriage. Daley was able to go out and do things with his children, too, making up for lost time when he was unable to do things and the kids were helping him cope with the pain.

“We love the boardwalk, playing the arcade games,” Daley said. “The first thing we all did was go to the beach. I was able to go dip my toes in the water.”

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Daley said the moment that really brought home how the surgery had changed his life, however, was something unexpected.

“We have a cat,” Daley said. “He’s huge, a Himalayan, and he’s got a lot of energy.” Before the spinal fusion, “I couldn’t play with him and he knew he couldn’t play with me.”

Then one day Daley bent down to grab a ball and toss it for the cat, named Snowball.

He did it without thinking about it … then realized he had not been able to do that before the surgery.

“It’s insane how well it worked,” Daley said. “I’m still limited to how much I can carry but being back to normal, just being able to take walks or tinker and build things,” is a much better life.

A last resort

Jandhyala, who said he has performed more than 100 of the spinal fusions like the one on Daley, said for someone suffering back pain, surgery is something that should be a last resort.

There are risks that go with it — risks of infection, of bleeding, a risk of injury to the nerve root that could cause other issues.

“We try to alleviate some of your pain nonsurgically,” he said. If that fails and it’s affecting the person’s quality of life, then surgery is a consideration.

Some people are not good candidates for surgery. “If you have someone who has a poor medical history, it won’t be in the patient’s best interest,” he said.

“If there’s someone really suffering and they have tried every kind of conservative management, it’s not unreasonable to talk to a surgeon about options,” Jandhyala said.

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