More than 90 percent of the people who have back trouble get well on their own using nothing more sophisticated than bed rest and aspirin. Light is a doctor of last resort, the kind about 1 or 2 percent of the chronic sufferers turn to when nothing else has worked-not the therapy, the injections, not the previous surgeries.
A carpenter he operated on had nine previous surgeries. Every one left him a little worse off. When Light opened him up, he found a loose screw left behind in the spinal canal from the last operation.
"They're at their wit's end, and this is the last straw," said Light.
Some chronic sufferers have lost their jobs, had marriages crack up and been told they're crazy. Others are advised to learn to live with their pain because it's never going to go away. A lot of doctors won't have anything to do with them, particularly if they've had back surgery before. Depression is common, as is addiction to pain-killers.
Spinal surgery isn't cheap. It can cost more than $55,000 counting hospitalization. It's also scary stuff with no room for error. Light admits to feeling fear before every operation.
The specialist Light studied with at Buffalo, N.Y. Edward Simmons MD-a legend in the field and a pioneer in making spinal surgery a speciality of its own within orthopedic surgery-gave him the courage to make the backbone his focus by demonstrating techniques few other doctors had mastered. Simmons, 62, was a founder of the Scoliosis Research Society in 1966.
"Spinal deformity didn't used to get so much attention," Simmons said. "When we first formed, we said maybe we wouldn't need to meet every year. But it has grown so much we didn't have enough room for the people who had things to offer., We had to insist that the papers be shorter."
Simmons uses a lot of "very" in describing his former pupil. "He gets along with patients very well, he's very devoted, conscientious, very honest, and very good. If I had to have surgery, I'd select him to do it." Light smiled when told. It was like being welcomed to the top of Olympus.
Perry was rolled into the pale green operating room, and anesthesiologist F.T. Choy MD put her into dreamland at 8:20 a.m. "Think of the foothills," he said as she went under.
Light has the same team whenever he operates. [Siteop Note: This is no longer the case.] "He expects nothing but perfection from everyone," said physician's assistant Veronica Gonzales. Chest surgeon Jack Ghantan MD opened Perry up from her front side, and her heart and lungs were nudged aside to give Light access to the spine.
Ballet dancer Sarah Oppenheimer, 35, of Mill Valley woke up one morning in January after a heavy season of "Nutcracker" and could hardly move. Many back stories begin with people waking up in the morning. Light is a neighbor, so she called him.
An MRI gave the bad news. She had two herniated discs in her neck, one of which was sticking into her spinal chord. "He said I was at risk of being paralyzed," During six hours of surgery, the disc was removed and replaced by bone taken from her hip.
"My long neck is the best part of my ballet body. I asked Ken if he would make the incision small. He told me afterward that he made it too small and it meant another hour on the operating table." It was six hours in all, fairly standard for spinal surgery, although Light has spent as much as 12 hours on a patient. Wearing an elaborate neck brace, Oppenheimer returned to ballet class within four weeks and has now resumed her career. She danced the "Nutcracker" again last season with Kirov ballet star Nikolia Kavaniaev. | 
