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Evelyn Williams

UCSF Surgeons Accomplish What Others Deemed Impossible

By Maureen McInaney

The Daly City resident was in her 20s when she was diagnosed with ankylosing spondylitis, an autoimmune disease that causes arthritis and fusion of the spine. As the discs between the back bones disintegrate, the spine collapses and fuses into one stiff unit, causing a forward curvature of the spine, explains Dr. Christopher Ames, UCSF neurosurgeon.

Though doctors could not tell what the future would hold, Williams, now 62, was determined to lead a normal life -- caring for her family and working as a nurses' aide at a convalescent hospital, a volunteer at her children's school and eventually as a medical secretary at the Presidio and Fort Baker Medical Base.

Her situation worsened in 1986 when she stopped her Volkswagen Bug at a base traffic light and was hit from behind by a military truck. An ambulance whisked Williams away with bumps, bruises and neck and back soreness that would heal in time, but her spine disease continued to advance.

To help abate the stiffness and lack of mobility in her spine, she continued to seek the services of physical therapists, chiropractors, acupuncturists, and massage therapists -- a multi-pronged regimen she had begun in her early 30s. "You name it, I tried it," recalls Williams. "I think I was in denial about the serious nature of my condition because I drove a car, cared for my two aging aunts, my husband, my own two children and my house -- just making the accommodations I needed to keep on with the daily tasks of living."

Eventually, her spine curved so far forward that her chin was virtually touching her chest, making sitting up in a chair and eating a challenge and driving a car impossible. She relied on a cane for balance. Her primary care doctor, Dr. Ann S. Omachi, an internal medicine specialist at Seton Medical Center in Daly City, referred Williams to several spine specialists. All said there was nothing they could do for Williams. But Omachi was adamant that something had to be done when Williams' breathing became labored because the bones of her rib cage could not expand normally.

Omachi recommended that Williams be evaluated by a California Pacific Medical Center orthopedist, who, in turn, referred her to doctors at the highly acclaimed UCSF Spine Center. Four months later, Ames and Dr. Philip Weinstein, UCSF neurosurgeon, operated on Williams to straighten and stabilize her spine.

In the 12-hour procedure, UCSF surgeons began by releasing the bones of Williams' spine -- literally breaking them in specified places and separating them to loosen the deformed curvature. They then re-aligned her cervical and thoracic spine, placing a series of rods and screws to maintain the bones in their new position. Of critical importance, the spinal cord was monitored in real time throughout the complex procedure, explains Ames, to be sure new bone placements would not impede its function.

Surgeons then placed a metal halo to immobilize her head, cervical and thoracic spine. Williams would wear the seven-pound device constantly for three months. Later, she was fitted for three braces that would allow her to resume a more mobile life -- a soft brace for sleeping, a plastic brace for the shower and a brace that stabilizes her shoulders and back but extends only to under her chin.

"Now, I have my life back," says Williams, explaining that she no longer has to look at the ground and can once again look people in the eye. With the help of her husband, Nathaniel, 65, a custodian for the Jefferson School District, and her daughter, Tracey, 38, a marketing specialist, Williams continues to discover new possibilities for her body and her life.

She has never been one to dwell on the negative. "It's always been important for me to keep a positive attitude. You never know what life will bring and you have to make the best of things."

Williams has follow-up care at UCSF Medical Center and gets regular, in-home assistance from a social worker, a nurse and a physical therapist. She credits her physical therapist for teaching her to walk again -- and the UCSF surgeons for being able to accomplish what others had said was impossible.

Story written in September 2003.

Related Information

UCSF Clinics & Centers

Rheumatology Clinic
400 Parnassus Ave., Floor B1
San Francisco, CA 94143
Phone: (415) 353-2497
Fax: (415) 353-2530

Neurology and Neurosurgery

Spine Center
400 Parnassus Ave., Third Floor
San Francisco, CA 94143-0332
Phone: (866) 81-SPINE or
(866) 817-7463
Neuro-spine Fax: (415) 353-2176
Ortho-spine Fax: (415) 353-4047

Conditions Treated