A Patient’s
Perspective:
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.
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.”
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.
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© 2006 Tri-State Neurosurgical Associates - UPMC
Last Updated: Mar 12, 2003