UCSD Neurosurgeon Is Helping Paralyzed Patients Walk Again With Unique Surgery

Rick Constantine was told he would never walk again after a car accident. But after four years in a wheelchair, Constantine, now 58, is walking again after undergoing an interesting surgery at UC San Diego.

Constantine, a former NASCAR crewmember, had surgery on a Friday and was in physical rehabilitation within days. And two weeks after his surgery he was walking—without a walker.

UC San Diego Dr. Justin Brown said Constantine had a brain stem stroke that caused paralysis on the right side of his body following the crash. He explained that his leg muscles became so severely spastic that he could not walk.

“Our team performed a delicate surgery to reduce input from the nerves that were causing the muscles to over contract to the point of disability,” said Brown, director of UCSD’s Neurosurgery Peripheral Nerve Program, in a statement.

The surgery is a procedure performed under a microscope. In the procedure, called a selective peripheral neurotomy, Brown made an incision behind Constantine’s knee to reach the tibial nerve. He then selectively trimmed back the troublesome nerve branches.“ Cutting the nerve reduces the ‘noise’ being relayed back to the spinal cord which causes the spasticity,” UCSD Health System explained.

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Brown said the advantage to this approach is that the muscle is preserved and there is no need to cut or lengthen the tendon. He added that selective peripheral neurotomy may be appropriate for patients with brain or spinal cord injury from strokes or tumors, cerebral palsy and multiple sclerosis.

“After surgery with Dr. Brown, I could put my foot flat on the ground to walk. With physical therapy, everything just gets better and better. I'm a firm believer in never giving up,” said Constantine.

Watch the video to the right to hear Constantine talk about his transition from a wheelchair to walking. He is featured at the 1:57 mark.