Life-Altering Spinal Surgery
When he retired from the military in 1994, he moved on to a career in information technology, maintaining his active lifestyle. Then, after retiring from his corporate career about ten years ago, he got involved in Palm Springs politics and was elected mayor of the city in 2015.
Toward the latter part of his four-year term, he started having back problems. He’d been rear-ended in a car accident in San Francisco about 15 years prior to this and the damage to his lower spine was coming home to roost.
“I had to take my written driver’s test when I turned 70 and I couldn’t stand in line at the DMV for any length of time because I was in so much pain,” he relates. It became difficult for him to keep up with his daily walking and three-times-weekly strength-training regimen. And he began to notice a grinding sound in his neck whenever he turned his head.
Then, in 2020, Moon and his husband — they’ve been together for 41 years — moved to Tamarisk Country Club in Rancho Mirage to be closer to their Eisenhower Health doctors.
“We were having some work done at our new home, and I went to check out the new steps into the pool,” he recalls. “I hit some tile dust, my feet flew out from underneath me, and I fell down five tiled concrete steps on my back.
“I thought I could shake it off and took some extra-strength Tylenol®, but the next day I couldn’t get out of bed and was screaming in pain,” he continues. His husband brought Moon to the Eisenhower emergency room where an MRI revealed that he’d suffered two cracked vertebrae.
“My fall exacerbated a problem that had been coming on for a long time,” he says. “They gave me a combination of intravenous morphine and valium to get me through the pain.”
But the relief didn’t last. When he returned home, Moon borrowed a walker from a friend in order to get around and he could only sleep sitting up with a pillow under his knees. He went back to Eisenhower.
“I couldn’t take care of myself, and I refused to leave the hospital until we could figure out what was going on and how to fix it,” Moon says. He was admitted as an outpatient for observation and underwent three days of tests. “Even though this was at the height of the pandemic, in November 2020, Eisenhower’s Covid protocols were amazing and I always felt safe, even though I was in pain.”
Prior to and during his hospitalization, Moon’s care was coordinated by his primary care physician, Sheda Heidarian, MD, who is Board Certified in Internal Medicine and Geriatric Medicine. He was also seen by Board Certified Neurologist Seymour Young, MD, and while in the hospital he saw Board Certified Neurosurgeon Farhad Limonadi, MD.
This care team — who Moon characterizes as “three of the most extraordinary, compassionate, capable physicians you’d ever want to encounter” — agreed that at this point their patient had two treatment options. The first was to continue the conservative course of anti-inflammatory medications and physical therapy he’d already begun under Dr. Heidarian’s and Dr. Young’s care. The second was to undergo surgery.
Time for surgery
“I told him I didn’t care,” Moon continues. “I was in pain all the time, I could barely walk and I wasn’t going to live like that after being active all my life.”
Dr. Limonadi acknowledges that lower back pain is an extremely common problem, affecting an estimated 50 million people worldwide at any time, surpassing the number of people who have heart disease, diabetes and arthritis combined.
“It’s the leading cause of disability, and you’d think there would be consensus on the best way to treat it,” he says. “Yet, according to a 2018 article in The Lancet (a renowned peer-reviewed medical journal), lower back pain is usually treated with bad advice, inappropriate tests, risky surgery and opioid painkillers, all of which go against treatment guidelines. It’s a complex problem that’s not managed in proportion to its severity.
“It’s critical to fully understand the underlying pathology that’s causing the patient’s symptoms,” he stresses. “Once you determine the specific cause, only then you can address it appropriately.
“In Mr. Moon’s case, he had obvious spondylolisthesis, what’s often called a slipped disc, when one vertebral body isn’t aligned on top of the other,” Dr. Limonadi explains. “He also had dynamic instability, and the nerve roots coming out of lumbar vertebrae 4 and 5 were pinched, which accounted for the pain radiating to his leg, thigh and groin, which was severe — an eight out of ten.”
With a clear picture of what was causing Moon’s pain, Dr. Limonadi performed an operation known as posterior lumbar interbody fusion (PLIF). It is an effective way to fuse two adjacent vertebrae, creating spinal stability and relieving spinal pain.
The procedure first involved a dual laminectomy (removing the lamina at L4 and L5). These are bony arches that stick out from the back of the spine, and removing them relieved the pressure on the compressed nerve roots. Then, Dr. Limonadi pulled the sloped vertebral bodies back into the proper position and inserted screws to immobilize them.
“The role of the screws is temporary since the bone itself will eventually fuse and stabilize the spine,” he notes.
An excellent outcome
The entire procedure took nearly six hours. When Moon woke up in his hospital bed, he refused narcotic pain medication and asked if he could get up. He did so on his own and when Dr. Limonadi came by to check on him postoperatively, Moon was sitting in a chair, reading.
“The strongest thing I took for postop pain was extra-strength Tylenol,” Moon says. He remained in the hospital for three days.
“That he was relatively pain free after such a complex surgery is telling about how great a pain threshold he has — and a gauge of just how much he needed this surgery,” Dr. Limonadi says.
Moon is effusive about the positive impact that spinal surgery has had on his life.
“My outcome could not have been better,” he says. “All the physical problems I had before are simply gone. I feel like I’m 40 years old again and there’s nothing I can’t do. I spent a year of lockdown getting back into shape and now I’m living my life again. My husband and I have made trips to New York City, Paris and Milan, going to the theater, visiting museums and walking for miles every day. I went to my fiftieth reunion at the Naval Academy. And we just booked a trip to Egypt and Jordan in the spring, followed by a trip to Greece and Israel. Then we head back to Europe for a five-week cruise.
He also serves on the boards of several community organizations and is now able to resume his involvement with them.
“When I was first incapacitated, I thought my life was over and I didn’t want to put my spouse through that,” he adds. “But Dr. Limonadi gave me my life back. He gave us both our lives back. And I feel so fortunate.”
To learn more about Eisenhower Neuroscience Institute, call 760.837.8020 or visit EisenhowerHealth.org/Neuro.
