John Hepler couldn’t ignore his back pain any longer. After years of suffering, the 47-year-old became depressed, hunchbacked and a liability at work.

The worst part: He no longer felt like the guy that his family needed him to be.

About 80 percent of adults experience low back pain at some point in their lives. And it’s the most common cause for job-related disability and a leading cause for missed days at work.

Chase Bennett, MD, Novant Health Brain and Spine Surgery
Chase Bennett, MD

Hope was restored when Dr. Chase Bennett, a spine surgeon at Novant Health Brain & Spine Surgery, recommended a new minimally invasive procedure called a lateral lumbar interbody fusion (XLIF).

For Hepler, it was a decision that changed his life.

Family first

Hepler is a self-proclaimed “Daddy’s boy.” Originally from Welcome, North Carolina, he used to wait by the window for his father to come home after a long day of work at R.J. Reynolds Tobacco Company in nearby Winston-Salem.

“Dad always made time for us,” he said. “I used to follow him into the basement where he taught me everything there is to know about woodworking.”

He also learned from his dad how to be a man of integrity, a loving husband and an engaged father.

Backbreaking work

Hepler has never shied away from hard work. After graduating from North Davidson High School, he went on to work in various manufacturing positions throughout his career. He also hit the jackpot when he met his wife “on the other side of these trees” in Clemmons, where they now live. Together the couple have three children and one spoiled grandchild.  

“I have always taken a lot of satisfaction in being able to provide for my family,” he said. “But after a career of hard labor, I started noticing pain in my lower back in 2013. At first, I thought it was just fatigue, but it only got worse.”

At that point, a non-Novant Health orthopedic practice gave Hepler two steroid injections to ease the pain. The injections worked for a few years, but the pain persisted.

“It got so bad that my posture began to change,” he said. “My boss and co-workers would see that I was hunched over all the time and I could tell they were worried about me.”

His pain led to depression. It also caused him to take a break from woodworking. “My mind wanted to do things,” he said, “but my body just wouldn’t let me anymore.”

Getting help

Slippage between L4 and L5 vertebrae
Slippage between L4 and L5 vertebrae.

Last year Hepler’s primary care provider, Margaret Bovender a family nurse practitioner at Novant Health Hillsdale Medical Associates, referred him to see Bennett.  

It was there that Hepler was diagnosed with severe disk degeneration and slippage between the vertebrae (spondylolisthesis). The culprit: Age-related wear and tear between the discs and small joints in his lower spine.

In Hepler’s case, the spinal column had shifted eight millimeters out of alignment and his pain level was constantly between a five and 10.

“I noticed right away that this was a guy that just wanted to get back to work to provide for his family,” said Bennett. “He knew surgery was the next step, but he was afraid of having to deal with a long recovery time that is common with traditional open back surgery.”

New procedure

Alignment restored after surgery.
Alignment restored after surgery.

Bennett recommended a new procedure in Winston-Salem, North Carolina, known as a lateral lumbar interbody fusion (XLIF).

This minimally invasive procedure only requires a small incision on the patient’s side, hence the word “lateral” in the name, as well as one or two small incisions on the back. From there, Bennett uses imaging and nerve monitors to guide his surgical instruments to reach the lower spine, or lumbar. At that point, he removes the diseased disc and replaces it with a titanium spacer implant to help improve the alignment of the spine and to take pressure off any nerves that have been pinched.

He then places screws and rods through small poke holes in the back to provide additional strength and stability without compromising the patient’s low back muscle.

Technology in the spacer is used to help stimulate bone growth so that the connecting bones in the spine will grow into and through the implant, making the spine strong and stable. The procedure takes about 90 minutes and most insurance companies cover it.

The procedure was successfully completed in August 2019 at Novant Health Forsyth Medical Center. Bennett says that this procedure is not for everyone, but that it was an excellent option in this case.

John Hepler with a few of his woodworking projects.

Back to what he loves

Hepler noticed an immediate pain reduction after surgery. He was also able to walk around and return home the following day. And after a four-month recovery, he is now pain free and back to work.

“I tell everyone I feel like Superman,” he said. “I had all of the faith in the world that Dr. Bennett could do it. And even at the hospital, he took the time to give my wife a call during the procedure to let her know how I was doing. He sees surgery from his side, but also from the family side.”

Hepler is also back to woodworking and spending more time with his kids.

“My family deserved this procedure,” he said. “I always want to be the person that they can call upon for help if they need it.”

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