Patient Perspective: Craig Cotton Discusses His Experience with Titan Spine’s Endoskeleton Implant
Three years ago Craig Cotton was an active triathlete, competing in half distance triathlons and finishing a full-distance Ironman in 2011. In 2012, however, Craig’s intense training regimen and competitive lifestyle came to a grinding halt when he suffered an isthmic spondylolisthesis (fractured spine) and L5 radiculopathy (nerve impingement that causes leg and back pain). At that point, Craig’s intense back pain became his biggest challenge, and his return to competitive sports, his family and his career was made possible through spine surgery using Titan Spine’s Endoskeleton Implant.
Engineer, Fitness enthusiast, Father of two
Diagnosed with isthmic spondylolisthesis in 2012
Suffered intense, debilitating leg and back pain
Fusion surgery with Titan Spine’s Endoskeleton implant in 2013
At 12 weeks post-surgery, completed a 100 mile bike ride
"This has been an amazing life changing experience for me."
Describe yourself before your injury.
Before my injury I was very active. I was training 20-25 hours per week. I had been experiencing some leg pain for quite a long period of time. In the summer of 2012, I was playing softball and running to first base when I felt a very intense pain down my right leg. Since then I had more severe pain as my training and softball playing went on. The intense pain was intermittent. After exercise I would have to use a pain reliever to relieve the pain.
How would you describe your pain?
I would describe my pain as an ache that extended from my upper hip down to the top of my foot, especially my big toe. It felt like a 20-pound weight on my foot.
How did your pain affect your quality of life?
Because of the pain, everything suffered. My family life suffered and I was very depressed. My work life also suffered. I was struggling with working full days. I work a desk job and sitting was very difficult for me. I would have to get up every 15 minutes and walk around. I was forced to leave work after about four hours of working and sitting. I would go home and sleep the rest of the afternoon. My body felt like it was shutting down completely. The onset of debilitating pain was about 6 months after my injury.
I had to stop running completely. Even walking was difficult. I would try to walk a mile and I would be in such pain afterwards that I couldn’t do it anymore. Sitting and sleeping were also very difficult. My sleep was interrupted due to pain so I would wake up in the middle of the night to take pain relievers in order to sleep well.
Endurance sports used to be a release for me. Taking those sports away took a sense of joy out of my life. I was taking it out on people at work and at home. It affected my identity as well.
What did you do to try to alleviate the pain?
I was doing yoga to try to alleviate the pain but getting into some of the positions would cause intense pain. So, I could no longer do yoga. I started going to physical therapy in January 2013 to somehow identify what was going on. I went to physical therapy for close to 8 weeks and that did not work. After physical therapy, they were treating me for a bulging disc. They sent me to an osteopath within the facility. After an evaluation by the osteopath I was put on a steroid called Prednisone to take down the inflammation. Prednisone had no effect whatsoever on my condition. Because I still did not have relief, my osteopath did an X-ray and an MRI. These tests revealed that my L5/ S1 was fractured in my back. At that point in my consultation they suggested I see Dr. Ullrich, a spine surgeon. My osteopath said Dr. Ullrich was someone he would refer to his best friend, brother, or any family member. He was very happy with Dr. Ullrich’s results.
What procedure did you decide to have and why?
After the consultation with Dr. Ullrich, the review of my X-ray and MRI and because of my condition with the L5-S1 joint, my doctors decided that a spinal fusion was the best option to stabilize my lower lumbar area and move forward with my life.
I wanted to do the fusion procedure because I wanted to improve my quality of life. After doing research on other types of procedures and materials for back surgery, I felt that Dr. Ullrich’s method was the most stable option and would last a long time.
[Note: Craig underwent a front/back fusion, with the Titan Spine Endoskeleton cage in the front, and with pedicle screws in the back.]
Did you have to do any special preparation for surgery?
I had no specific preparation for surgery. I swam up to the day of surgery to stay somewhat active. Being the type of personality that I am I needed to do something to keep my body in shape.
How did your surgery go for you and how did you feel immediately after surgery?
The surgery went very well. The only thing I remember is walking into the operating room and waking up in the recovery room. It seemed quick.
Immediately after surgery I felt much better. I actually gained mobility in my toes. One of the effects of my condition was to lose mobility in my feet and my big toe especially. I was also having weakness in other areas. Right away I noticed that scrunching my toes together could be done without pain or cramping. Cramping was another issue, my muscles would lock up when I moved my feet. I was in the hospital overnight and I was up and walking 2 to 3 hours after surgery. I went home the next day. I went in at 8am on Wednesday and home at 11am on Thursday.
The first 4 to 5 days were tough after surgery. There was a lot of pain associated with surgery, especially on my back. You have to be flat on your back after surgery. The incisional pain was the most painful part of the surgery. I was still able to get up and walk around frequently. Actually walking around and standing was the most comfortable for me. Lying down was the hardest part. The first week was difficult but I was able to manage with pain meds.
How did you feel two weeks after surgery?
Two weeks after surgery I was able to start walking outside. The first walk was ½ block and back. The walk was slow and I was stiff. I didn’t have back pain or incisional pain after that. The discomfort I felt was muscle weakness. The surgery cuts into the abdominal muscles and lower back muscles. So when you’re trying to stabilize yourself you have to use those muscles. It was tough to try to keep comfortable and not stretch it out too much as you’re walking along.
How did your health progress one month after surgery?
Four weeks after surgery I was up to walking 3 miles per day. After I was able to walk outside, things really started to progress quickly. My healing and my sleeping became much, much better. I was able to get comfortable in bed by rolling on my side or stomach and that helped a lot. I slowly increased my walking routine. I started at a ½ block, then a block, pretty soon I was up to a mile and two miles and by week four I was walking three miles. Two months after surgery I was back on my bike again doing some work on my trainer which is a stationary bike. I was doing 30 to 45 minute workouts on my bike.
How did you progress from there?
By ten weeks, I was on the road again doing 25 to 30-mile rides. By twelve weeks, I completed a 100-mile bike tour around the Fox Valley. It was the Gourmet Bike Tour outside of Neenah, WI. After I was on my bike, everything felt very good. I gained confidence in my abilities and strength, and I took off from there. Before surgery, I was struggling to walk and I couldn’t ride my bike anymore. I was losing a lot of strength in my legs and hamstrings. Three months after surgery I was completing 100 mile bike rides, riding 250 miles a week, my strength was coming back and after any bike ride or any type of exercise I had zero pain in any part of my body.
How has your life been impacted since receiving your Titan implant?
This has been an amazing life changing experience for me. I feel that before surgery I was not mentally there for my children. That was the biggest issue I had. I was tired. I was in pain. My only focus was the next time I was able to rest. I realize now after surgery how much of my boy’s lives I was missing. I have two boys, four and six years of age. My four year old has special needs. He doesn’t walk and I have to carry him. You can imagine how difficult it was to transport him anywhere with the lifting. Now I am able to lift him and play with both my boys. This has been an amazing experience. I would absolutely recommend this procedure.
Do you have anything to add for other patients considering back surgery and a Titan implant?