Freeze, who writes a column in the Salisbury Post called “Gotta Run,” had good odds for success, Eline said. Unlike many patients his age, his bones were strong.

“He was also in shape, not obese and was motivated — extremely motivated — and was willing to undertake certain risks because of the kind of activities and goals he had,” Eline said.

Simply put: Freeze couldn’t imagine his life without biking and running. His cross-country cycling adventures have been chronicled in many of his 10 books, and after almost 50 years of running and 24 marathons, he was on the verge of a much-anticipated milestone.

Metal rods and pins? No.

The fall put it all at risk. One of his fractured vertebrae — T12 in the lower back — would be a relatively routine repair. But the other — L3 a little farther below — was not only severely compressed, it was also fragmented. Because it had almost burst, fixing it was no sure thing, and Eline didn’t mince words about the risk.

“I told him you may have 100% success, or you may get no relief whatsoever,” he said. “And then, we’d have to go back in … and put metal rods in your back.”

That was the last thing Freeze wanted to hear.

Metal rods were exactly what doctors recommended at the trauma center (not part of Novant Health) where Freeze was taken after his accident. He had been in the emergency room for hours, unsure of his status, when a doctor on duty recognized him as an old family friend.

He reviewed Freeze’s chart and told him he was headed for the operating room come morning. Surgeons planned to fix the fracture with rods and pins, an appropriate but potentially life-changing treatment for his injury.

“He told me, ‘Nothing will be the same about your life if they put a rod on each side of your spine and a bunch of pins to hold it in place. You’ll have no mobility,’ ” Freeze recalled.

When morning came and Freeze was asked to OK the spinal fusion, he got straight to the point: Would he still be able to cycle and run after the surgery?

“The doctor said, ‘No … nothing like that ever again,’ ” Freeze recalled. He’d have to scale back on heavy lifting around the farm, too. “Well, then,” Freeze responded, “I don’t want it.”

Back surgery recommendation: Kyphoplasty

Three days later, he headed home in a back brace, and drawing on his expertise as a fitness coach, would soon embark on a do-it-yourself rehab regimen.

He started slow, walking his gravel driveway from end to end and back again — about 0.2 mile in all — with his nephew carrying a chair alongside, just in case. A day later, he did it twice. And within six weeks, Freeze was cutting the lawn, leaning on his sturdy, professional mower for support.

“I ended up mowing 3.2 miles,” Freeze said. “So I began walking, and I worked my way up to 5 miles.”

One day, a fellow member of the Salisbury Rowan Runners club and doctor of physical therapy told him about kyphoplasty, a treatment to stabilize compressed bone that was less likely to limit his activity. Word-of-mouth and Google led him to Eline.

But Freeze wasn’t over the finish line yet: His insurer put one final hurdle in his road to recovery, refusing to cover the procedure. He felt so strongly that kyphoplasty was his key to an active life that he was willing to pay out of pocket and made a $6,000 down payment.

Five months after his accident, he was finally on the calendar for back surgery at Novant Health Wilson L. Smith Outpatient Center in Salisbury.

On operating day, Freeze was in and out in roughly three hours and walked to his car afterward on his own power. Concerned about risking the tricky L3 repair, Eline told Freeze to keep moving but not to run until his next visit.

“I waited till two days before the appointment, and then I went to a flat part of the road here, close to the farm and ran a half-mile just like any other time,” he recalled. “There was no pain. I was in tears then, and I’m a little bit in tears telling about it now.”

Hitting the 100,000-mile running mark

A year after his fall, Freeze runs 4 to 6 miles a day and thanks God for steering him to Eline.

Recent imaging shows that the repair is not only holding, but that bone is starting to grow around it, the best possible outcome. “It should be a permanent repair,” Eline said.

On April 18, less than a year after his injury, David Freeze reached the milestone he’d chased since the 1970s. With his 5-year-old granddaughter, Monroe Bishop, running at his side for the last half-mile, he hit the 100,000-mile mark.

What is balloon kyphoplasty?

Balloons and cement are a 21st-century surgical treatment for compression fractures of the spine.

The treatment is called balloon kyphoplasty, (pronounced ky-PHO-plasty) and Dr. Gene Eline of Novant Health Orthopedics & Sports Medicine – Manning Park in Salisbury, North Carolina, has performed hundreds of these outpatient procedures in more than 20 years of spine surgery.

Compression fractures occur when all or part of a vertebra collapses, often due to the bone-wasting disease osteoporosis. Simply put, balloon kyphoplasty restores the integrity of the fractured vertebra, allowing for pain-free movement.

It’s performed with the patient under general anesthesia. Continuous X-ray imaging lets the surgeon view the vertebrae from front-to-back and side-to-side.

To begin, tiny incisions are made on either side of the spine. Roughly the size of a No. 2 pencil (about 1/10 inch), these allow for insertion of a hollow tube called a cannula through which the operation is performed.

Using a tiny drill, the surgeon enters the bones and clears away any fragments. A balloon is then threaded through the cannula, placed into the vertebra, and inflated to get the bones back in place. The space created is then filled with a quick-hardening liquid cement that solidifies the bone and prevents it from further collapse.

Once the patient is awake and the anesthesia has worn off, they can get up — and go. They’re usually directed to take things slow but keep moving. Stitches are typically removed about two weeks later.

“By the next morning, most patients notice a substantial improvement in their condition,” Eline said. “Typically, no physical therapy is needed.”

But, he added, each patient is different. This procedure is not for every spinal condition. It is only used to treat compression fractures, which are typically caused by severe osteoporosis or spinal tumors.