Steven Sandberg, a 68-year-old pianist and composer who lives on Manhattan’s Upper West Side, experienced serious injuries when he was hit by a truck in his late 20s, but fortunately his spine was spared any damage. Even so, he endured chronic back pain that has waxed and waned ever since.

For decades, chiropractic care, physical therapy, and exercises kept the pain at bay. But starting in 2021, shooting pain down his legs prevented him from standing up straight or finding a comfortable position for lying down.

“It was worse than it’s ever been,” he says. “I was getting desperate.”

In April 2023, Sandberg consulted Maria Janakos, MD, a physical medicine and rehabilitation specialist at NYU Langone Health. When an MRI revealed severe stenosis, a narrowing of the spaces within the spinal canal, Dr. Janakos referred him to orthopedic surgeon Charla R. Fischer, MD, whom she described as “the most minimally invasive surgeon you’ll find.” Dr. Fischer is also a co-director of the Endoscopic Spine Surgery Program.

Dr. Fischer explained to Sandberg that the stenosis was caused by a combination of instability of his second and third lumbar vertebrae, L2 and L3, and a cyst in the same area.

The good news was that Dr. Fisher was able to offer Sandberg an innovative procedure that lived up to her reputation for taking a conservative approach to surgery. In 2022, spine surgeons at NYU Langone adopted a minimally invasive surgical technique for lumbar conditions called endoscopic transforaminal lumbar interbody fusion, or TLIF.

“What makes endoscopic TLIF a game changer,” explains Dr. Fischer, “is that through two tiny incisions—one for a camera and another for instrumentation—we disrupt very little soft tissue, enabling the patient to make a faster recovery, with less pain. Given Steven’s cyst and instability at only one level, I knew he would be a good candidate.”

“What makes endoscopic TLIF a game changer is that through two tiny incisions—one for a camera and another for instrumentation—we disrupt very little soft tissue, enabling the patient to make a faster recovery, with less pain.”
—Charla R. Fischer, MD

On September 18, 2023, Sandberg had a three-hour operation. First, Dr. Fischer removed the joint that was causing the cyst. Then she removed the disc, decompressed the nerves, inserted a spacer, and placed a bone graft. Finally, using robotic techniques, she inserted screws and then connected them with a rod. Sandberg went home five days later, immediately starting outpatient physical therapy.

“I feel 20 years younger,” he says. “Dr. Fischer did an amazing job. I’m a supersatisfied customer.”

Learn more about spine health from our experts in Your Spine: An Operator's Manual.