Minimally Invasive Cervical Fusion Relieves Pain
Eight years ago Frances Walinsky began to experience significant and persistent pain in her neck. Her doctor prescribed physical therapy, and after a few months of therapy she began feeling much better. Fast forward to the present. Now 61 and diagnosed with arthritis in her neck, Frances began having tingling sensations down her right arm and into her hand. When her family doctor ordered cervical films, the results showed that her condition had further deteriorated, and that she now had several herniated discs in her neck that were impacting her spinal cord. At this point her doctor referred her to a neurosurgeon to seek a consult.
When Frances met with the neurosurgeon, he explained that he would need to perform a surgical procedure known as an Anterior Cervical Discectomy and Fusion (ACDF). In this procedure, the surgeon makes an incision in the front of the neck and dissects in between the carotid artery, esophagus and trachea in order to reach the front of the cervical spine. Then the affected disc is removed, and a spacer is introduced where the disc had been. Over time, the vertebrae will then grow (fuse) together, and pressure against the spinal cord is alleviated. In order to maintain proper spacing and stability while the bones grow together, a small metal plate is typically affixed to the front of the disc space via screws into the bone above and below.
Here’s a good video that describes this procedure:
As Frances was considering her options, she saw this story that Washington, DC’s NBC 4 ran, highlighting a new type of spinal surgery that made use of robotic guidance systems for more accurate and predictable outcomes, eliminating the error of the human hand. The story featured Dr. Jae Lim, a board-certified spine surgeon practicing in Northern Virginia. Intrigued, Frances scheduled a consult with Dr. Lim.
When Frances met with Dr. Lim, he explained to her that the robotic system he uses facilitates a minimally invasive approach to the posterior approaches to the thoracolumbar spine. The procedure that she would need is an anterior cervical approach which does not require robotic guidance. However, Dr. Lim advised Frances that she would be a candidate for an advanced technology beginning to be used for ACDF procedures. He explained that he would use a new device that included an integrated plate and spacer system. With a traditional ACDF procedure, the plate that is affixed to the front of the vertebrae can rub up against the patient’s esophagus, causing an uncomfortable and sometimes painful sensation. With Globus Medical’s COALITION®, the sagittal anatomic profile is preserved while providing the same anterior column support and stability that a traditional plate does.
What’s more, in Frances’ case, she needed to have the procedure done across multiple levels. Since the COALITION® device can be used at multiple, contiguous levels of the cervical spine (C2-T1), it was a good option for her procedure.
After consulting with one other spine surgeon, Frances decided to have Dr. Lim do the procedure using the COALITION® device and minimally invasive techniques he described. She underwent surgery in the morning and stayed overnight in the hospital for observation. Everything went according to plan, and the next day she was released.
Amazingly, Frances took no prescribed pain medications after leaving the hospital. While the back of her neck was sore for some time after the surgery, she took a course of extra strength Tylenol and muscle relaxant, gradually reducing the dosage over the course of 12 days until she was completely off all medications by the day 12. Within two weeks she had enough range of motion in her neck to where she could get back to driving again. She said the most pain she had was in her throat, a result of being intubated during the surgery.
Frances says that she is grateful for the new technology that helps to minimize trauma, reduce recovery time, and improve upon traditional methods. She believes that new technologies like robotic guidance techniques that guide minimally invasive spine surgery is definitely the way to go, and that the COALITION® device provides a less intrusive resolution to disc fusion.
Frances’ advice to anyone who has a degenerative neck or spine condition that will only get worse over time is to not put off having surgery. “If you wait, my experience has been that the recovery takes longer because there’s been more damage prior to getting the surgery done.”