Jamie Rossouw, 36, is a self-confessed workaholic. He started his appliance store when he was just 18, and as he had a small team to begin with, he had to do a lot of the heavy lifting himself. Although he was very fit, participating in cross-fit training, boxing and running, the backbreaking work he did eventually took its toll.
“I sell household appliances, and back then, I was lifting between 200 and 300 appliances each day. These included stoves, fridges, washing machines, and tumble driers.”
When Rossouw started to experience lower back pain, he began a journey that would eventually lead him to consult a South African orthopaedic spine surgeon who is doing groundbreaking work, for a lasting solution to his debilitating problem.
After consulting other medical practitioners without success, in desperation Rossouw began to do his own research. “I thought, surely, there was another way to treat this and discovered that there was an endoscopic procedure being done in the USA. I was even exploring the possibility of going to see a surgeon there. But then, on Google, I found that Dr Shawn Venter, who operates from the Spine Centre at Netcare Kuils River Hospital, is charting the way forward for biportal endoscopic spinal surgery in South Africa.”
| Dr Shawn Venter is an orthopaedic spinal surgeon practising at Netcare Kuils River Hospital whose field of interest and expertise is minimally invasive spinal surgical techniques. |
| Scrub nurse Zanele Khonkotha (left) and general practitioner Dr Leonie Bell (right) assist Dr Shawn Venter in theatre at Netcare Kuils River Hospital. |
Rossouw had a special reason for wanting to be well. His honeymoon was coming up.
“Dr Venter put together a plan for how I could go on honeymoon without having severe back pain. He suggested an interventional pain procedure to address the pain sources as a conservative approach. After the honeymoon, I’d return and re-assess the need to consider having a discectomy.”
But, this was not to be after Rossouw unluckily contracted hepatitis and had to postpone both his honeymoon and the interventional pain treatment. After he recovered from the hepatitis, he had the discectomy done to alleviate his leg and back pain in September 2023. But, unfortunately, his leg pain returned a few weeks after surgery and Dr Venter diagnosed a re-prolapse.
“This fairly rare occurrence happens in only about five to ten percent of people after a discectomy,” explains Dr Venter. “Again, all efforts to treat his pain conservatively to acceptable levels failed.”
Dr Venter and Rossouw then chatted about two options: repeating a discectomy or doing a spinal fusion. “After a long discussion, taking into consideration all factors, Rossouw decided that despite his young age, the endoscopic spinal fusion would provide lasting relief. Also, taking into account the demands of his work, he needed to be able to do all the heavy lifting without any concerns about his back.” The biportal endoscopic spinal fusion was agreed upon as the next step.
Dr Venter explains that although the literature quotes longer theatre times for endoscopic fusions, he has been able to reduce his surgical time to less than that of open surgery, with a single level spinal TLIF (transforaminal lumber interbody fusion) taking less than two hours. This procedure means there is much less surgical trauma to the patient’s back muscles, which means fewer risks and less post-operative pain compared to traditional open surgery.
“Blood loss is reduced and there is a lower infection risk as the wound is constantly irrigated during the procedure. There is also no delay in mobilising a patient post-operatively, and Rossouw returned home three days after his spine fusion fully functional, able to sit, stand and lie down with no restrictions. He was able to resume driving after 10 days.”
Dr Venter’s work has not gone unnoticed. Recently, he was invited to speak at the prestigious annual Congress of Spinal Endoscopy in France to share how he managed to reduce the time of biportal unilateral endoscopic TLIF surgeries to below two hours.
“Worldwide there are less than 100 surgeons currently performing this endoscopic fusion surgery, however this number is growing exponentially as the benefits of this type of surgery become more evident,” says Dr Venter.
He explains that a spinal fusion is made up of small procedures put together. “First, we do a decompression to open up the space for the nerves, then a discectomy to take out all of the diseased disc. The void is filled with a spacer and bone-graft harvested locally, and lastly, screws keep everything in place while the bone grows into the vertebra.”
Dr Venter says that the minimally invasive approach provides hope for patients previously deemed unfit for spinal surgery. “I’m now able to offer surgical relief to a wider range of patient demographics compared to the past. These include patients with extreme BMIs – like BMIs of 60 – who wouldn’t even be considered for open surgery, elderly patients, as well as those requiring simple and multilevel fusions. Probably the most beneficial component is that frequently a more targeted type of endoscopic surgery can be performed, rather than altogether avoiding spinal fusion.”
He cautions that an open or endoscopic fusion is always the last resort surgery, but it’s a very good choice when the indications are right. “Patients present with back pain and leg pain – nerve impingement pain. They will have exhausted all conservative management options, pain procedures and physiotherapy. We always have to make a good diagnosis of the pain source and give them all the treatment options available so they can make the best choice on what suits their lifestyle. My biggest joy is seeing the patients benefit from this. When you see the patient outcomes, you realise it’s worth every minute of it.”
However, he adds that not everyone can benefit from an endoscopic fusion. “We try and find a solution for everyone. If a patient is not a candidate for endoscopic surgery, my partner, Dr Reggie King, has an amazing skill set for salvage and deformity correction surgery.”
Dr Venter says he chooses to operate at Netcare Kuils River Hospital because the theatre he works in is specially modified and automated, with larger space to allow for the specialised equipment he uses. “It includes a navigation system, which is a powerful 3D reconstruction of the spine that I can scan in theatre as well as the best endoscopic tools and cameras. The unit has also been set up to allow optimal training of other surgeons.”
A much-relieved Rossouw said his recovery had been “absolutely amazing”. “I’m a workaholic and I’m young, so instead of going to the stepdown clinic after my hospital stay, Dr Venter let me go straight home. I had two weeks of rest and did some walking, and then I was back to work using my back brace. It made things a whole lot easier,” he says.
“I’ve worked extensively with a personal trainer and done the necessary core exercises. I go for needling and physiotherapy to make sure the muscles there are not too tight. At 16 weeks post-surgery, I’ve even started running slowly. I’m feeling great, and I’m over the moon with the way things have worked out.”
He’s feeling so well that he’s now making up for lost time. He’s rebooked his honeymoon and has also planned a separate trip to Zanzibar.
Rossouw has taken valuable life lessons from the experience.
“I’ve learnt recently that health is wealth. For anyone with back pain, go and seek the help of a professional. Don’t self-medicate, don’t Google and don’t do things on your own. See a physiotherapist or an orthopaedic surgeon like Dr Venter and put together a proper care plan.”
Ends
Contact the Netcare Kuils River Spine Centre on 021 872 2236 or 021 903 2696 should you have any queries or visit our website and book a consultation online at www.spinecentre.co.za. Alternatively, contact the Spine Centre via e-mail on [email protected] or [email protected] to book an appointment.
Notes to editor
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