Posted by Brigham and Women's Hospital February 11, 2014
For many years, Diane Daigneau of Woburn, MA, was able to successfully manage her back and neck pain. Through occasional chiropractic treatments and mild pain relief medications, she was able to continue to work and play.
A few years ago, however, she discovered that circumstances can change dramatically, to the point where even the best non-surgical care fails to provide adequate relief. Such was the case during the summer of 2013, when the pain radiating through Diane’s back, neck, and arms had become so debilitating and persistent that no physician was recommending anything other than cervical spine (neck) surgery.
From Manageable to Intolerable
Diane likes making things pretty. More than that, it’s her job.
She often spends several hours hovering over a single piece of furniture while meticulously applying delicate gold or silver leafing, or some other type of elegant exterior. It’s a mentally and physically demanding job, particularly for someone who has struggled with back and neck pain. But Diane’s pain was never so bad that she ever worried about not being able to do her job or any other enjoyable pursuits. That changed suddenly during a family vacation at the end of July 2013.
Diane woke up on the second morning of her vacation with a new kind of pain. “The pain was unbearable,” says Diane. “It was something like I had never experienced before. There was nothing I could do.”
Along with intense pain, she had limited range of motion in her neck and numbness throughout her neck, shoulder, arms, and chest. Her succinct assessment: “I knew something wasn’t right.”
She ultimately headed back home for an MRI, which revealed that two herniated (bulging) discs were crushing nerves in her cervical spine.
A Surgical Solution
Through a colleague, Diane was referred to Brigham and Women’s Hospital spine neurosurgeon Dr. Michael Groff for a consultation. Based on her condition, Dr. Groff recommended a two-level anterior cervical discectomy (disc removal).
Dr. Groff started the procedure by approaching Diane’s spine through the front of her neck instead of through her back. There are two distinct advantages to this method. The most important is a significantly reduced risk of damaging the spinal cord. The other is less cutting of muscle, which helps to reduce postoperative pain.
Once the affected area of the spine was reached, Dr. Groff completely removed both bulging discs to take the pressure off of the nerves. Next, to maintain the integrity of the spine, he snugly inserted a graft into each area where a disc had been removed.
The carbon fiber cages used for Diane’s surgery are now the standard of care for discectomy and fusion in Dr. Groff’s practice, and a significant advance from the combined use of grafts (natural or synthetic) and titanium plates. A multi-center study, in which Dr. Groff participated, demonstrated that using a carbon fiber cage alone provides the same strength and functionality as provided by a graft and titanium plate. However, the comparative simplicity of the carbon fiber cage – less material, fewer parts – decreases operation time, reduces the impact on surrounding tissue, and minimizes manipulation of the esophagus.
Diane admits that her recovery hasn’t been easy, but neither has it been a surprise. “I knew all along, step by step, how things were going to be for me,” she explains. “It’s not fun, but at least you’re feeling confident that things are going in the right direction.”
Dr. Groff is similarly confident about the progress of Diane’s recovery. He told Diane that the carbon cages and fused vertebrae eventually will make her neck so strong and stable, as strong as it was before, that she could participate in extreme sports within a year.
Although she finds that claim to be reassuring, Diane doesn’t plan on jumping out of any airplanes in the near future. She’s quite happy to simply be walking, jogging, working – or waking up – without the fear of back and neck pain.– Chris P.