Minimally-invasive spinal surgery helps Motocross rider return to racing

Since he was a young five years old, New Jersey resident Demetrius Economou has been tearing through the woods on a Motocross bike. A long-time family passion, Demetrius learned to ride when he was just 5 years old and riding quickly consumed his life and became a constant thought on his mind. While many children were playing team sports like baseball or soccer, Demetrius was learning how to modify his 70cc bike to keep up with the bigger bikes. As he grew, Demetrius moved up to the larger bikes and eventually, he entered the highly competitive world of Motocross racing. He spent several days at a time traveling around the country to compete in different races and events. Where he chased sponsorships and endorsements and had garnered considerable success.

These races and events often involve a significant amount of bodily stress and strain as riders attempt to negotiate their 200-pound bikes around hairpin turns. For added excitement and intensity, these tracks often utilize dirt jumps in which riders speed up a ramp elevating 15 feet in the air before landing back on the dirt.

The same elements that add the thrills and excitement to these races are often the same ones that increase the propensity for injury. "As a rider descends from a jump and his bike makes contact with the hard dirt, all of the concussive force is absorbed by the spine. At the speed the rider is traveling and the distance from the peak of the jump to the ground, the force that is absorbed by the spine can be hundreds of pounds per square inch," says Dr. Richard Kaul. "Most often the rider is in a semi-seated or crouched position; therefore, the majority of the force is absorbed by the sacroiliac (SI) joints, which is where the lower back meets the hips."

This repetitive, concussive force is what caused Demetrius to begin experiencing chronic and debilitating pain in his lower back and hips. "In the beginning, I would use a cane or crutches when I was walking. Then, it came to the point where, if I was walking, I had to be near a wall because, sometimes it was so painful I could not even stand up, and I would need to brace myself against a wall just so I would not collapse," recalls Demetrius. "I was in so much pain at that time that riding was not even a consideration. I could not even stand, let alone get on my bike and ride."

In 2010, after meeting with a menagerie of specialists, Demetrius consented to arthroscopic hip surgery in an effort to relieve his pain. Sadly, months after that surgery his pain had not subsided and he still remained sidelined from competing. "After doing some more research, I was convinced that what I had was a spine issue, and I went to see the chief spine surgeon at a major hospital. He told me that there nothing he could do and that pain pills were the only treatment. There was no way I was going to live like that."

Finally, in late 2011, Demetrius met with Dr. Richard Kaul at New Jersey Spine and Rehabilitation. "The first thing I told Dr. Kaul was that my goal was being able to ride again, and that was all I was concerned about," says Demetrius. Dr. Kaul examined Demetrius and reviewed his imaging studies. He diagnosed Demetrius with severely degenerated SI joints. This was the pain generator for his extreme lower back and hip pain. Traditionally, SI joint injuries were either not treated at all or required a large incision through the midline of the back. "Demetrius' SI joints were in dire need of fusion to stabilize his spine, but more importantly, to relieve his pain." says Dr. Kaul.

Foregoing the traditional "open" approach to an SI fusion, Dr. Kaul informed Demetrius that his surgery could be carried out using a minimally-invasive approach and Demetrius would return home from surgery the same day. The minimally-invasive approach significantly reduces the amount of dissection and manipulation that muscles and tissues are subjected to during a traditional approach. Additionally, the minimally-invasive surgery is carried out through a small incision; only a few millimeters, to access the spine.

Demetrius consented and underwent minimally-invasive sacroiliac joint fusion in January of 2012. Today, he is pain-free and working hard at physical therapy. Most importantly, Demetrius happily reports that he is actively preparing for his return to Motocross riding, something that was not even a consideration six months ago. "You know, everybody you talk to about pain tells you something different," Demetrius says. "People tell you to go see their chiropractor or physical therapist or acupuncturist, but I knew within five minutes of meeting Dr. Kaul that he was the right physician for me."

Source New Jersey Spine and Rehabilitation