Gunnery Sergeant Jeff Morin was leading a training exercise in 1993 when one of his recruits fell from the sky.
The Marine plummeted from the top of the rope climb, and landed squarely across his drill instructor’s shoulders.
“I took the full brunt of his fall,” Morin said. “Just like a hammer hitting a nail.”
The accident in San Diego paralyzed Morin’s left leg and required emergency back surgery the next day. Doctors put Morin under anesthesia while he lay on his stomach and removed bone fragments and four herniated discs.
While Morin lay face down during his procedure, patient repositioning has long been the gold standard for more complex spinal fusion procedures. For example, in some traditional fusions of the lower lumbar spine a patient may have part of the procedure on their abdomen, would then be flipped on their side for another step of the procedure and then be flipped again for placement of screws at the back of the spine. But more surgeons are beginning to agree this approach is too time-consuming, and a risk that keeps the patient under anesthesia longer than necessary.
At 32, Morin found himself on non-duty for the first time in his military career. He left the hospital in a wheelchair.
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Recovery was a painful slog that never truly subsided. It began with Morin bedridden for a month. His muscles atrophied without the military discipline of exercise and resistance training. Once he was back on his feet, he couldn’t muster the strength to walk uphill or upstairs. Morin underwent three months of physical therapy and rehabilitation before he returned to limited duty.
Wear and tear caught up with Morin over the decades. In 2009, the veteran of Iraq and Afghanistan retired as a sergeant major with the U.S. Marine Corps.
By last year, it was getting harder for him to walk with balance. Driving and sleeping also felt worse by the day, and Morin’s hip flexors locked up whenever he raised his arms. Doctors discovered that his lumbar spine had severely degenerated, so much so that it had buckled under the weight of his torso. Morin dreaded another surgery but knew he had to address his back again.
“I’ve been in constant pain for the last 20 years,” Morin said. “My quality of life had gotten to a point where I knew I had to take care of it and start living life again.”
That led to research online, where he found Dr. J. Alex Thomas, a neurosurgeon at Atlantic Brain & Spine in Wilmington. Thomas in 2013 helped pioneer research on the Lateral Single-Position Surgery (LSPS) technique. Here, the patient lies only on their side—in the lateral position—for all stages of the operation. LSPS is faster and less invasive, Thomas said, and was better suited to Morin’s condition.
“Given the deformity that he has, and that he’s an exceptionally motivated patient, I knew that he would be an excellent candidate for reconstructing that part of his spine,” Thomas said.
Morin, now 62, met with Thomas several times before agreeing to the procedure in December 2022 at Novant Health New Hanover Regional Medical Center. Morin said the surgical team fully briefed him on timing and what to expect.
“I had no questions,” he said. “They didn’t make me feel like I was part of an assembly line. It was extremely well-run, and any anxiety I could have had was alleviated by those briefs.”
Morin said the difference between his two operations, almost 30 years apart, was immediately clear.
“With the first surgery, the cure was almost as bad as the injury,” Morin said. “The second surgery was far less debilitating.”
And it lasted only one day. On New Year’s Eve, with the help of a walker, Morin left the hospital.
Shorter surgeries, faster recoveries
Thomas remembers being yelled at during a conference 10 years ago. Fellow surgeons criticized him for endorsing LSPS, which they assumed would be unsafe.
But it was far riskier to continue flipping patients like rotisserie chickens, Thomas told them. “You can spend all day just repositioning the patient,” he argued, which keeps them under anesthesia for more time. Thomas and another surgeon performed their first LSPS in December 2013 at New Hanover Regional Medical Center.
Earlier this year he co-authored a clinical study of 442 spinal-fusion patients; some underwent LSPS while others were flipped during surgery. The study reported that LSPS requires less operating time and creates fewer postoperative complications. Morin’s surgery last December was done within three hours.
“That was just unheard of before,” Thomas said. “And it’s not just about going home, it’s about getting up and walking right away. There’s no question that the recovery is better and much less arduous.”
Still, no matter the technique, recovery from fusion-surgery is slow, an estimated 18 months in Morin’s case. Morin was walking shortly after his second surgery but acknowledges a long road ahead, and is counting the days.
“I’m doing well, but I don’t want anybody to think that this is a piece of cake, either,” said Morin, who works as a vice president for a defense contractor.
“I’m not skipping around town yet, but I’m able to walk three-and-a-half to 4 miles a day now. I’m probably in Chapter 2 of a 10-chapter book. I’m making these little milestones in how I get better.”