by Tony
Sometime in 1999 or 2000, Tony began to be bothered by what he referred to as a “crick in the neck.” The symptoms would show up two or three times a year and last for a couple of days.
“I wouldn’t be able to turn my head without pain,” said Tony. “I had gone to a chiropractor a few times, but the symptoms would always come back after a while. Eventually, I felt some pain in the top of my left arm as well, and the pain slowly moved down to my hand. That was about the time [in 2003] that I went to see Dr. Hartman.”
Dr. Mark Hartman of Total Spine Specialists surmised that Tony was suffering from a compression of the spinal cord or a nerve root in the cervical spine—conditions known as myelopathy or radiculopathy, respectively. The most common cause of compression is agerelated degeneration—also known as spondylosis—but tumors, infections and fractures may also lead to compression.
Cervical radiculopathy usually results in upper extremity pain, weakness and/or numbness. Myelopathy often has more subtle symptoms such as difficulty performing fine motor functions, muscle wasting, gait disturbance and incontinence or retention in the urinary or gastrointestinal system. These symptoms are often masked by other medical problems and are commonly misdiagnosed. In Tony’s case, Dr. Hartman ordered a few tests before making a diagnosis. “At first, we thought it might just be a problem with a disk,” Tony said. “I had an MRI, but Dr. Hartman requested a CT-scan because he wanted to make sure we knew what we were dealing with. It confirmed that I had a growth like the knot of a tree that was pinching my spinal cord.”
Modern imaging technologies like the MRI, CT or CT/myelogram accurately depict compressions, and this visual information is vital for prescribing treatment, whether surgical or nonsurgical. Non-operative treatments include non-steroidal anti-inflammatory drugs, physical therapy and injections. Unfortunately, once a patient develops progressive radicular weakness and pain, or the symptoms of myelopathy, these treatment strategies are often ineffective. Surgery, however, is usually quite successful in treating the condition at this stage.
For Tony, surgery was the only option. He hoped to postpone it until after the NASCAR season in order to complete his duties as for a NASCAR race team, but Dr. Hartman wouldn’t condone any further delay. “He told me that if I were involved in a minor car accident or some other event like that, it could leave me paralyzed. I had to have it taken care of immediately.”
Surgical options to treat this condition include anterior decompression and stabilization, posterior decompression with or without stabilization, or a combined anterior/ posterior procedure in the most complex cases. Dr. Hartman performed anterior decompression with stabilization on Tony, the most commonly used procedure, because cervical compression is easily accessed from the front of the spine. He removed two of Tony’s cervical discs completely and replaced them with a titanium plate and screw to enhance stability.
“The rehabilitation process actually went faster than I had expected,” Tony said. “After the surgery, I was in the hospital for a couple of days and wore a nylon neck brace for about two weeks.” He soon switched to a soft collar and was able to return to work.
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