Pilates & Spine Surgery

Pilates teachers have many clients who find us specifically because they suffer from back pain. When author and educator Deborah Spungen, MSS, MLSP, CTS arrived at my studio she was experiencing debilitating and excruciating pain which interfered with her life and her work. As founder of the Anti-Violence project of Philadelphia, she trained and lectured to social workers, police officers, and families of murder victims.

Spungen, then in her early 60s, became a Pilates client in November 1997, six months prior to a scheduled anterior/posterior total lumbar fusion graft surgery. She had severe lumbar scoliosis and stenosis with posterior/right herniations of every lumbar disk, which led to neurological symptoms--pain and numbness in her right hip and down her leg and a general weakness and collapsing of her right side which also affected her shoulder girdle and scapular stability. This would have led to loss of bladder and bowel control just before right leg paralysis. Her pelvis was very unstable (a prior Pilates teacher put her on a Ball which led to pain for days after the session!).

Prior to her surgery I gave Spungen small extensions and neutral pelvis work, primarily supine. NO rotation, NO hyperextension; NO unstable surfaces; NO working off the ground (i.e., hanging on the Cadillac); and NO resistance/pressure loading of her spine (tower, short spine). My role was to help stabilize her lumbar spine/pelvis, to work on mobilizing the other areas of her spine and torso that had become rigid to compensate for the lumbar instability, and hopefully to relieve some of her pain.

Spungen showed particular weakness in her pelvic floor, gluteals, transverse abdominus, both sets of obliques, iliopsoas, and hip abductors and adductors. Despite her movement limitations, she always left the studio feeling better and standing taller.

In the surgery they first took bone from her iliac crest to use for the graft. Then they sliced her from sternum to pubis anteriorly and removed all disc material and articular cartilage. Taking a femur from a cadaver, they sliced and shaped the bone to fit into the disc space. They filled the femur with Spungen’s bone and grafting putty and replaced each disc with this mixture.

Then the surgeons cut her posteriorly from the middle of her back (around T7) to her sacrum. They decompressed her spine and stabilized it using more bone graft and a series of staggered rods on either side of the spine that are held in place with titanium pedicle screws. The entire operation took about 8 hours. Spungen says, "I was filleted, with incisions down my back, down my abdomen, and at my hip where they took the bone for grafting. But, I still felt much better than before the surgery."

After surgery Spungen first worked with an aquatic Physical Therapist, returning to the Pilates studio after three months. With the help of the Physical Therapist we worked to regain specific muscle strength and joint mobility. I also incorporated energy healing into her sessions.

Spungen's surgeon approved all movement except spinal rotation and hyperextension. Although she had some post-surgical movement restrictions I was able to add new exercises. While the basic goals and format of her Pilates sessions did not change drastically, her surgically repaired lumbar spine was inherently more stable. We began to do more movements in sitting and standing which helped her balance; and were also able to work more on flexibility and range of motion, especially in her ilio-tibial band now that she did not have to rely on it as much for stability.

After the fusion Spungen had to deal with a broken right leg and meniscus repair surgery!! But she made it through both with no recurrence of her back problems. Her surgeon is impressed. She feels and looks great, walking, biking, and swimming and generally being more active than most of her contemporaries. "My surgery was successful, but without Lynda's assistance and Pilates, I know that I would not have have recuperated so quickly, nor would I have attained the high level of functioning that I enjoy today."