Anterior Cervical Discectomy with Bone Fusion and Plate
History

Mr. Robert Bear* is a 41 year old engineer who enjoyed good health until August 25, 2002.  While swinging a golf club, he noticed immediate acute left shoulder pain.  “I didn’t think much of it until after the round, when the pain worsened and traveled to my neck and left arm,” said Mr. Bear, “ I knew something was definitely wrong after I began to have trouble sleeping because of my severe neck pain.” These symptoms persisted and he was evaluated by his PCP and was started on PT for two weeks.  “I began to notice my left upper arm was getting smaller and I was getting weaker in my left tricep,” said Mr. Bear. He then underwent a MRI demonstrating a large herniated cervical disc on the left C6-7 nerve root. (See side X-ray)

He was then evaluated by Dr. Maroon and found to indeed have left tricep muscle weakness and abnormal reflexes in the left arm.  Following a discussion of the risks and benefits of surgery he agreed to have an anterior cervical discectomy and fusion with bone graft on 10/10/02. “I knew I couldn’t wait any longer, even my co-workers noticed that my left arm was getting small from the muscle atrophy,” stated Mr. Bear, “and my left forearm and first finger and thumb were completely numb.” “It was hard to believe that a herniated disc in my neck was the cause of my severe left arm pain and numbness,” said Mr. Bear.

Surgery and Hospitalization

Mr. Bear underwent the operation without complication and was discharged the day after surgery. “I was immediately better when I woke up in the recovery room.  The worst part of the surgery was a sore throat that only lasted a few days,” stated Mr. Bear.  “I still occasionally have some slight numbness in the tip of my left index finger but my strength is continuing to improve and I am able to do most activities.” “Overall I am very satisfied and glad I didn’t wait any longer,” said Mr. Bear.

*Mr. Bear has signed a released to permit the release of this personal information.  We will not disclose any information unless the parties involved agree in writing.  Mr. Bear chose to permit this information because of his gratitude to Dr. Maroon and his staff.

Anterior Cervical Discectomy with Bone Fusion and Plate

Phyllis Wilson* has lived a very healthy and active life for the last 79 years.  She tends her flower garden, uses her NordicTrack™ and takes long walks in her neighborhood.  But this healthy lifestyle changed about two years ago following a trip and fall accident.  She suffered, what was diagnosed at the time as having, a “whiplash” injury. Her pain was severe in her neck, shoulder, upper back and left arm with numbness and tingling into her hand.  “My life changed”, stated Mrs. Wilson, “I stopped walking, tending my garden and almost every activity I did due to my constant severe neck pain. I was convinced I was doomed to a future of continuous suffering.”  The drawing shows her pain distribution.  “I was in such agony that I drew a crude picture to help describe where my pain and numbness were”, stated Mrs. Wilson.

Mrs. Wilson saw a chiropractor who recognized her symptoms were more than a simple whiplash.  She was placed in a soft collar and treated with magnetic therapy and sent her for further evaluation.  See had a MRI and plain X-rays and was then seen by Dr. Maroon for an evaluation.

She was found to be suffering from severe neck spasm and profound pain with movement of her neck. The MRI showed spinal degenerative disc disease at C4-5 and C5-6, but more importantly her flexion and extension cervical X-rays (see

photos) showed abnormal spine alignment and abnormal movement of her spine. Dr. Maroon told her that she needed a spinal fusion at those levels to stop the movement and most likely relieve her pain.

She underwent a C4-5 and C5-6 anterior cervical discectomy and fusion with bone and a plate (see photos).  “It is a miracle”, states Mrs. Wilson, “I am back to walking, house work and my gardening. And best of all my neck has no more spasm or pain when I move it. I have experienced a metamorphosis in my life.”

Mrs. Wilson’s  results are usual of this operation. Each patient’s recovery differs and depends on many factors. Age, sex, type and amount of disability and length of symptoms all play a role in the recovery process. Our goal in all cases is to allow the patient to resume all the activities they did prior to your injury whenever possible.

*Mrs. Wilson has signed a released to permit the release of this personal information. We will not disclose any information unless the parties involved agree in writing. Mrs. Wilson chose to permit this information because of her gratitude to Dr. Maroon and his staff.

Anterior Cervical Discectomy with Bone Fusion and Plate
History

Mr. Richard McDonald* is a 35 year old director of sales and marketing who has enjoyed good health until the summer of 2001.  Mr. McDonald, an active water skier, states he began to have right shoulder pain and numbness into his right hand fingers.  These symptoms persisted and he underwent a MRI demonstrating herniated cervical discs at both the C5-6 and C6-7 levels.  He was then evaluated by Dr. Maroon and found to also have right biceps muscle weakness and abnormal reflexes in the right arm.  Following a discussion of the risks and benefits of surgery he agreed to have an anterior cervical discectomy and fusion with bone graft and anterior plating on 9/27/01. Prior to surgery Mr. McDonald voices some concerns.  “How can this be a neck and disc problem when my right arm hurts?  Will I have the same mobility and get back to the things I did before my problem occurred?” Finally,  “Can’t I wait a while longer before surgery?”

Discussion:  Mr. McDonald’s concerns are very common and were addressed prior to surgery as follows:

1.      “How can this be a neck and disc problem when my right arm hurts?”

Your arm hurts because the herniated disc is compressing your nerves that exit the spinal cord in the neck area.  Therefore, if we remove the pressure from these nerves your arm symptoms should improve.

2.      “Will I have the same mobility and get back to the things I did before my problem occurred?”

Most people are able to resume full activities after this type operation and after a recovery period.  This period of recovery may include physical therapy and other reconditioning measures in order to resume your activities. As everyone differs in his or her response to surgery we can’t be sure everybody will be able to water ski, as Mr. McDonald hopes to do, but most people do resume their normal activities of daily living.

3.      “Can’t I wait a while longer before surgery?”

The extent of your disability before surgery often determines the amount and rate of recovery after surgery.  We almost always recommend some form of conservative therapy prior to surgery, but the longer you have a neurological deficit (weakness, numbness, etc.) the longer it takes for the body to heal after the surgery is done to correct the nerve compression.
Surgery and Hospitalization

Mr. McDonald underwent the operation without complication and was discharged the day after surgery. “I was immediately better when I woke up in the recovery room, and my arm pain was gone”, stated Mr. McDonald.  “I felt better than I had in three months.”

He was discharged in a neck brace and asked not to do any strenuous activities, including driving himself, until his follow-up appointment with Dr. Maroon in four weeks.  “I had a sore throat and some mild stiffness in my neck after surgery, but this was minor in comparison to my previous pain”, said Mr. McDonald.  “Overall, I was ready to leave the hospital the next day.”

Discussion:  His relief is common after this type of operation and is shared by most patients.  Sore throat, persistent hand or arm numbness, however, is not uncommon.  The neck brace that is often used can also cause a pain in the neck, but frequently improves over time. Most patients are discharged one or two days after surgery and all will need to be seen back by their neurosurgeon with in four weeks with a neck (cervical) spine X-ray.  See side X-ray.

Recovery

Mr. McDonald was recently seen back by Dr. Maroon on 10/30/01.  His X-rays showed good spinal alignment and he was allowed to remove the neck collar.  He was asked to demonstrate he right arm strength and his sensation was tested.  “He examination after surgery is now normal”, states Dr. Maroon.  “And I will recommend progressive return to all activities at this time.”  Because Mr. McDonald is an active sports participant he was recommended to start in therapy program to strengthen his arm muscles and help his endurance.

“I feel great, and I am back to most of the activities I participated in prior to my injury”, states Mr. McDonald.  “I have full mobility of my neck and my neck scar is almost gone.”  “I am very pleased with how my surgery went and recommend this to anyone who would need this type of operation.”
Discussion

Mr. McDonald’s results are typical of this operation.  He will be permitted to go back to work, as he does not do heavy lifting.  Patients with more physical work may require a work hardening program prior to resuming work or they may need “light-duty” for some period after the surgery. Each patient’s recovery differs and depends on many factors.  Age, sex, type and amount of disability and length of symptoms all play a role in the recovery process.  Our goal in all cases is to try an allow you to resume all the activities you did prior to your injury.
*Mr. McDonald has signed a released to permit the release of this personal information.  We will not disclose any information unless the parties involved agree in writing.  Mr. McDonald chose to permit this information because of his gratitude to Dr. Maroon and his staff.