Knoxville woman takes holiday for cervical fusion
Angela Schubert had avoided surgery long enough. The pain in her neck and the tingling and spasms in her arms had made her miserable for almost a year.
When it was almost Thanksgiving 2018 and her daughter would be home to help, she decided to go for it – a four-level fusion of the C3-7 vertebrae. One day before Thanksgiving, the 57-year-old product manager for a medical manufacturing company got herself a “new” neck.
In what she remembers as a four-hour procedure at Parkwest Medical Center, orthopedic surgeon Luke Madigan, MD, performed what is called an anterior cervical discectomy and fusion. The procedure completely eliminating the pain she had felt for almost a year.
“The relief was immediate,” said Schubert. “Dr. Madigan is wonderful!”
Nearly a year earlier, she had awakened to what she thought was a simple “crick” in her neck. As the days went on, the pain grew steadily worse.
“I would literally be in so much pain that just getting up in the morning, taking a shower and doing my hair was all I could do,” she said. “I’d do all that through pain and then go to work and work through that pain. By the time I got home, all I wanted to do was lie down, because I was just exhausted from the constant pain.”
She tried ointments, pain relievers, water-cooled blankets and so many heating pads that she now jokes she’s planning a yard sale. After trips to the emergency room and a chiropractor she tried physical therapy, but it did not provide relief.
Schubert turned to Dr. Madigan for help, but was still reluctant to undergo the surgery her arthritis, degenerated discs and spinal stenosis would ultimately require. An epidural steroid injection stopped the muscle spasms on her right arm, but she continued to have pain on the right side of her neck.
Dr. Madigan then ordered radiofrequency ablation on her neck to decrease pain signals. “That worked perfectly,” Schubert said. “I no longer had the neck pain, but I was still having the shoulder and arm pain. That’s when I decided enough was enough, and to go ahead with surgery.
“Dr. Madigan told me what to expect. . . He put me at ease,” she said. “Going in, I was not scared. I was actually relieved because I knew I was going to feel better.”
She now looks forward to doing things like crafts that she didn’t have the energy to do before. “I’m starting to get back to my old self again. My coworkers see that and they see me smile and they know that I’m not in pain. It has really improved my quality of life. It has changed my personality, too. I’m ordinarily a happy, active person – and last year, all I wanted to do was lay around.”
Schubert was discharged from Parkwest Medical Center on Thanksgiving Day. Unable to swallow well for a few days, she had to pass on the Thanksgiving turkey. Instead, she says, “I ate mashed potatoes. Lots of mashed potatoes.” She returned to work the following Monday.
Although she had not been at Parkwest in several years, she was pleased with her care. “They have really elevated their care and what they offer patients and their families,” she said. “My room was nice. My daughter stayed overnight with me and they even catered to her by checking to see if she needed things. The nurses took such good care of me. They were right there any time I needed anything.”
Schubert also lavished praise on Dr. Madigan. “Dr. Madigan is caring and wants to fix the problem,” she said. “He’s got a big heart and wants to improve people’s quality of life. That’s what we need in a doctor when we are in chronic pain. Thank you, Dr. Madigan!”
What is spinal stenosis?
Spinal stenosis is a condition in which the spinal canal narrows and pinches the nerves, resulting in back and leg pain.
In adults 50 years of age and older, the risk of developing spinal stenosis increases. Younger people who are born with a small spinal canal may also develop symptoms. Aging can cause the ligaments (tissues that connect the spine and bones) to become thicker and calcified. The disks between vertebrae break down. Growths called bone spurs may occur on bones and into the spinal canal. All of these conditions tighten the spinal canal. This causes spinal stenosis.
Symptoms of spinal stenosis include pain and trouble walking, as well as numbness, tingling, a sensation of hot or cold, weakness or a heavy, tired feeling in the legs. A person may also experience clumsiness or frequent falls. Often bending forward – such as by leaning on a shopping cart at the grocery store – will lessen the pain.
If you experience any of these symptoms, talk with your healthcare provider. He or she may recommend pain medicine or corticosteroid injections to reduce swelling and pain, posture changes, physical therapy, or weight loss. Surgery may also be an option.
Surgical treatment for spinal stenosis is considered after nonsurgical remedies have not improved symptoms, and when the benefits of surgery are greater than the potential risks. In some cases, surgery may be an urgent matter due to the development of severe weakness or loss of bowel and bladder function
What’s causing your neck pain?
Because of its location and range-of-motion, your neck is often left unprotected and at risk for injury. Neck pain can range from mild discomfort to disabling, chronic pain. That pain may show up as tenderness, stiffness, spasms, burning or tingling. Sometimes it can show up as weakness in your arm or hand, pain in the back or shoulders, or headaches.
Neck pain can be caused by many different things, including injury, age-related disorders, and inflammatory disease. Potential causes of neck pain may include:
- Injury (damage to the muscles, tendons, or ligaments)
- Herniated disk in the neck
- Arthritis (such as osteoarthritis or rheumatoid arthritis)
- Cervical (neck) disk degeneration
- Congenital (present at birth) abnormalities of the vertebrae and bones
Along with a complete medical history and physical exam, diagnostic procedures for neck pain may include:
- Blood tests to help diagnose underlying inflammatory disease.
- Electromyogram (EMG) to evaluate nerve function.
- Magnetic resonance imaging (MRI) for make detailed images of organs and structures within the body. MRI can often identify damage or disease of internal structures within our joints, or in a surrounding ligament or muscle.
- Computed tomography scan (also called a CT or CAT scan) shows more detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.
Surgery is generally considered after all other treatments have failed. Other treatments may include:
- Medicine (to reduce inflammation and control pain)
- Physical therapy
- Osteopathic manipulation
- Neck brace or immobilization
- Massage therapy
Early treatment of neck pain is recommended in order to prevent future injury or damage.