Spine Surgery
Back to 100 Percent
Sarah Schotanus Raymond will never forget the week of July 4, 2017. While most people were preparing for cookouts and fireworks, she was suffering from intense pain that started in her neck and shot down her arm, forcing her to lie on her hardwood floor.
“That was the only way I could get comfort,” recalls Sarah, 41, of Whitinsville, who at the time worked as a pediatric nurse. “The weekend before the Fourth, it felt like a kink in my shoulder, and every day it got a little worse. I was having pain in the lower left arm and numbness and tingling in the pointer and middle fingers. By July 3rd, the pain was so debilitating that I couldn’t do anything. It got so bad that I was out of work that summer. Holding babies for vaccines would make my arm lock up from the elbow to my hand. I couldn’t drive for long as it would take my breath away.”
After seeing a physician for consultation, Sarah had an MRI and electromyography (EMG), a diagnostic procedure that evaluates the health condition of muscles and the nerve cells that control them. Unfortunately, the recommended treatments- physical therapy, cortisone injections, epidurals and oral medications failed to help. “Not even the heat packs I lived on helped,” says Sarah, who was working and raising two children now ages 15 and 12. “I put the heat packs on multiple times a night and was taking ibuprofen several times per day. It was a constant pain right at the base of my head.”
When it became clear that Sarah would need surgery, she was referred to Symeon Zannikos, MD, a spine surgeon at Orthopedics New England in Hopkinton.
Dr. Zannikos explains that the cervical spine is made up of seven bones, called cervical vertebrae, stacked on top of each other and forming the neck area. The cervical discs are the cushions that lie between the vertebrae, acting as shock absorbers and allowing the neck to move freely. Sarah had coped with chronic neck pain on and off for twenty years, seeing a chiropractor when necessary, but never experiencing a violent flare-up until that fateful week. Dr. Zannikos notes that a sudden escalation of symptoms isn’t unusual for those with cervical disc problems.
“Degenerative issues tend to wax and wane and flare up,” he states. “Some people find that every time it flares up, it is a little worse. A lot of people with degenerative issues wake up one day and know when it’s time to get treatment. For Sarah, it was disc herniation that was pressing on the nerve which makes it inflamed. A herniation is when a piece of the disc has come loose from the remainder of the disc, like the jelly leaking out of a jelly doughnut. She had 5-6 herniations at two levels in her neck. A lot of people tolerate the neck or back pain they’ve been dealing with, but having nerve pain shooting down the arm or leg is usually what pushes them over the edge. There can also be numbness and weakness.”
Dr. Zannikos relates that herniated discs are the most common ailment he treats and that in about 95 percent of cases, the symptoms will resolve without surgery within six-12 weeks. The standard initial treatment involves physical therapy, medications, and spinal injection procedures. “Over time, the disc gets smaller and the body absorbs it so that the nerve gets less inflamed,” Dr. Zannikos explains. “Unless it’s a really pressing issue, or someone like Sarah who has tried different things, I’d say wait it out and use injections and medication to deal with the pain. My job is to educate people about what their options are.”
At Sarah’s appointment, Dr. Zannikos outlined the pros and cons of two options: disc replacement and spinal fusion. “I thought he was great, very professional with a great bedside manner,” says Sarah. “I really had confidence in his decision-making. He thought I was a good candidate for the disc replacement, so that’s what I went for, and I’m so glad I did.”
Dr. Zannikos explains that disc replacement surgery—in which the damaged or degenerated cervical disc is removed and replaced with an artificial disc device—typically allows more movement and creates less stress on the remaining vertebrae. Alternatively, spinal fusion permanently connects two or more vertebrae in the spine, eliminating motion between them. The surgeon places bone or a bone-like material within the space between vertebrae, and then metal plates, screws and rods may be used to hold the vertebrae together.
“The pro of disc replacement is that you’re less likely to need another surgery in the future, especially if you’re doing more than one level,” says Dr. Zannikos. “Some studies show a faster return to work. A good candidate is someone with arm pain, mainly disc-related issues, and little arthritis. A candidate for a fusion would have a lot of wear and tear, bone spurs in the neck, or need more than two levels done.”
Cervical disc replacement surgery is only FDA-approved for up to two discs—which is what Sarah had replaced—and takes about forty-five minutes to an hour per level, relates Dr. Zannikos. The surgeon makes a small incision in the front of the neck, usually less than one inch.
“The neck has a natural pathway to the spine in the front,” he notes. “We excise the disc, and the replacement is a small prosthesis of medical plastic that slides and moves and restores the normal movement of the disc. For most neck surgery, the recovery isn’t very long as we minimize how much muscle and soft tissue is cut. The arm pain for the majority of people goes away immediately. When they wake up, most if not all of it is gone. They may get a few zings as it heals and their neck might be a little stiff for a while, but they don’t have the nerve pain they came in with, which is a significant improvement.”
Sarah had the disc replacement surgery at Milford Regional on January 23, 2019. Because her surgery was later in the day, she was admitted overnight. According to Dr. Zannikos, most patients return to normal activities by six weeks. Sarah started orientation at a new job three weeks later. “I just have the tiniest little scar on my neck,” she says. “There wasn’t much pain from the surgery, and the nerve symptoms stopped immediately. It was a huge relief.”
Sarah says her quality of life is much improved. She can even do fitness challenges, yoga, and high-intensity interval training, a big change from when she couldn’t manage any exercise.
“There's no pain anymore,” she marvels. “I can actually function and use my arm. I can walk my three dogs and not have to worry about them taking off, and can go hiking with them and the kids. I’ve recommended Dr. Zannikos to a few people who have had bad back issues. He's a wonderful doctor, and I was so happy I went to Milford Regional. It’s great to have a community hospital and not have to travel. I just feel 100 percent better.”
Learn more about Symeon Zannikos,MD, or call 508-458-6050 to schedule an appointment.
