When leg and back pain from spinal stenosis became unmanageable, this performer sought treatment and reclaimed his active life.
“My history with back pain goes back 30 years,” said Bruce Turner, 73.
Now, thanks to lumbar decompression surgery at Princeton Medical Center, Turner’s pain can remain in the past.
Like several of his family members, Turner was born with congenital scoliosis at the bottom of his spine, but he didn’t let it stop him from living a full and active life—much of it on his feet. He waited tables for years, then taught music, art, and theater to junior high and high school students for 40 years, enjoying a vibrant singing career on the side.
Periodically, Turner’s back would go out or he’d experience sciatica on his right side and pain in his left hip. But for the most part, he was able to keep his back pain under control with exercise and occasional chiropractic adjustments.
Two years ago, the pain in his left hip became too much to manage, so he underwent hip replacement surgery.
“The surgery was successful, and I was feeling great. Then in physical therapy, a couple of exercises caused me pain. I went back for a follow-up visit for my hip and was told my hip was fine, but there was very little space between the last couple of vertebrae in my back, because of arthritis,” he said.
Once more, Turner tried to manage his pain with exercise, visiting the gym every day to ride a bike, but he could no longer use the treadmill or take the long outdoor walks he’d always enjoyed.
Nerve compression from spinal stenosis
Last August, following a particularly long walk-in town, meandering up and down hills, Turner’s pain had shifted from his ride side to his left. “I knew I had a new problem,” he said. He called his hip surgeon’s office and asked for a referral to a spine specialist.
Hesham Saleh, MD, the orthopedic spine surgeon who treated Turner, said, “He saw one of my partners first. At the time, Bruce was having shooting pain in both legs that worsened anytime he was standing or walking for long periods. It made it extremely difficult for him to work anymore.” Retired from teaching, Turner now sings professionally for a church, which requires a lot of standing.
An MRI revealed lumbar stenosis, or compression on the nerves of the lower back. Saleh explained that spinal stenosis can happen anywhere along the length of the spine. Lumbar stenosis affects the lower back and causes symptoms down the legs.
Saleh compared the wear and tear of lumbar stenosis to what happens when you drive a car for a long time: Eventually the tires will wear.
Following evidence-based protocols to start with conservative (less invasive) pain management, Turner’s doctor prescribed physical therapy, followed by epidural steroid injections to the nerve roots. Neither provided long-lasting relief, so Turner asked about surgical solutions. That’s when he was referred to Dr. Saleh.
A surgical solution brings permanent relief
“Studies show that 85 percent of patients get better without surgery,” Saleh said. “Only after conservative approaches fail will we start discussing surgery.”
“I examined Bruce and saw that he had two levels in his lower back with significant stenosis,” Saleh recalled. Saleh sent Turner to a physiatrist for one more round of steroid injections to those specific areas, which helped temporarily. This confirmed for Saleh that he had targeted the right locations.
“Since he had good pain relief from nerve root injections at those two levels, I was confident that if I addressed those levels surgically, he’d wake up with significant pain relief,” Saleh said.
In January 2024, Saleh performed lumbar decompression surgery (laminectomy) on Turner, removing bone spurs and ligaments that were pushing on the nerves in two areas of his lower spine.
“The spinal canal is like a tunnel. When the tunnel is super tight, the nerves inside are compressed. What I do during lumbar decompression is take the roof off the tunnel, which takes pressure off the nerves,” Saleh explained.
Saleh said the other surgical option he had considered was a lumbar decompression with fusion—using screws and a rod to stabilize the spine at the levels of stenosis, which wasn’t necessary in this case.
“The fusion requires a longer recovery and given his age, I typically like to do the least amount of surgery that I think will solve this problem,” Saleh said. Saleh believed he could relieve 90 percent of Turner’s symptoms with just a laminectomy, thus avoiding a bigger surgery.
The procedure went well, and Turner was walking the hallways of Princeton Medical Center with a physical therapist that same day. Two days later, he went home with a lower back brace (to wear for six weeks) and a prescription for physical therapy.
“I did the eight sessions of therapy, and the main thing we worked on was my core strength,” Turner said. “As a singer, I’ve been working on my core for 40 years, so my muscles came back pretty quickly.”
As someone who’s proactive about his health, attuned to his body, and used to being in control, Turner appreciated his surgeon’s advice regarding his recovery. “Dr. Saleh said to get out of my head and relax. He explained that there would be some aches and pains as I healed and it would just take time,” Turner said.
Turner is back to singing at church and mostly pain-free. He continues to prioritize exercise, visiting the gym regularly and taking long walks once more. “The most profound change is I’m standing up straight for the first time in 20 years,” he said.
Before retiring from teaching, “I used to work seven days a week. Now it’s my time,” Turner said. “That’s why I did the surgery—so I can do the things that I want to do.”