Michael Kweder’s back problems began in his mid-20s following an automobile accident. Years of playing hockey and football in his younger years and decades spent working as a chef — a physically demanding job — also took a toll.
“I worked hard and I played hard,” he says.
Over the years, Michael had several back surgeries culminating in a spinal fusion in 2019. A year later, he stepped outside his Brookline home in Pittsburgh and slipped on icy steps, landing on his back.
Later that day, Michael noticed something odd.
“I could feel something poking into my back. I knew it wasn’t right,” he says.
The Challenge: Excruciating Pain
Michael didn’t know it at the time, but the fall had loosened the screws and cage used to fuse together vertebra in his lower back. This resulted in a failed fusion — a painful condition called pseudarthrosis. He was prescribed pain medicine and physical therapy, but the pain only grew worse.
“I was in constant pain — a level 9 or 10 — 24 hours a day. Pain meds helped a little, but not much and not for very long,” says Michael, now 63.
“I had always been extremely active. But after my fall, all I could do was sit on the couch feeling miserable and depressed. I needed a walker just to get from one room of my house to the other.”
An X-ray revealed significant flatback deformity, which is a loss of curvature in the lower back. It also revealed abnormal motion in his fusion. Corrective surgery was necessary — one that required highly specialized skills.
The Path to UPMC
Michael was referred to Thomas J. Buell, MD, a UPMC neurosurgeon and a specialist in complex spinal deformity surgery.
“I was pretty desperate when I went to see him,” says Michael. “I was falling deeper and deeper into depression. I needed to get my life back.”
When he arrived for his first appointment with Dr. Buell in March 2022, Michael was bent forward and unable to straighten up. He used a walker and couldn’t take more than 40 steps without tiring.
“When Dr. Buell looked at my back, he said he’d have to replace all the metal,” says Michael. “But he was confident he could get me straightened up.”
Dr. Buell ordered many imaging tests, including X-rays, MRI, and CT myelogram scans of his entire spine, looking for instability, pseudarthrosis, and associated stenosis, or narrowing. Dr. Buell also sent him to UPMC Children’s Hospital of Pittsburgh for EOS X-rays. This specialized low-dose X-ray showed Michael’s whole body from his head to his toes. The workup allowed Dr. Buell to measure the curves in Michael’s spine and plan for his corrective spinal deformity surgery.
“Dr. Buell was very thorough and precise. He explained that one little error in the measurements could throw everything off,” says Michael.
“I wasn’t worried. I had confidence in him.”
The Solution
On Sept. 9, 2022, at UPMC Presbyterian, Dr. Buell began the first of two surgeries to correct Michael’s pseudarthrosis and spinal deformity. The second surgery took place two weeks later.
In addition to replacing and upsizing the screws and rods from the previous surgery, Dr. Buell corrected the curvature of Michael’s spine using transforaminal lumbar interbody fusion (TLIF) cages and osteotomies. An osteotomy is a deformity correction procedure where a wedge of bone is removed to allow for realignment. Dr. Buell extended the fusion to the T10 vertebra and pelvis. By doing so, he corrected the curvature and improved the alignment of Michael’s spine.
“He had a lot to do, but he got it done. He did exactly what he said he’d do,” says Michael.
The Results
Michael’s recovery was slow. He had complications related to other health issues that required treatment, including atrial fibrillation and a recurrence of kidney cancer.
But since his surgery, Michael has regained mobility and has much less pain. He now stands upright and no longer needs a walker. He’s even been able to go camping and hiking with friends.
“Dr. Buell gave me my life back,” he says.
Michael says the surgery also has enabled him to set new goals.
“Three years of sitting wasn’t good for me,” says Michael. “But I’ve got plans now — walking more and losing weight. I have Dr. Buell to thank for that.”
