Vim & Vigor - Summer 2019 - UVA - 54

LEAVING PAIN BEHIND

A Pain in the

NECK
Sometimes surgery is the best option

T

54

SU M M ER 2019

spinal cord compression that can lead
to difficulty walking and impairment of
fine motor skills."

Discs in Decline

The vertebrae or bones of the spine are
connected by rubbery discs that cushion and stabilize the spine. These discs
can dry out and degenerate over time,
resulting in torn or herniated discs that
irritate the nerves, causing symptoms.
An X-ray and MRI revealed that Kiser
had two herniated discs in the cervical
spine (neck). To alleviate her symptoms, Dr. Yen recommended physical
therapy and steroid injections. "For
most patients with herniated discs, we
try conservative treatment first," says
Dr. Yen. This includes rest, reduced
activity, physical therapy, massage
and steroid
injections.
"Typically
after six weeks
if there is no
relief, then
we begin to
explore surgical options,"
he adds.

Optimal Outcomes

Despite regular physical therapy and
steroid injections, Kiser's pain and
numbness persisted. Only then did Yen
recommend surgical options to relieve
her symptoms. "Surgery was the last
resort. I was scared-any surgery at
my age is risky. But Dr. Yen explained
things so thoroughly. I call it a Mickey
Mouse presentation, but it was very
visual, which was very helpful for me,"
says Kiser.
The recommended surgery, anterior cervical discectomy and fusion, is
one of the most common procedures
to treat herniated disc, and doctors
have been performing it for decades
with positive outcomes, says Dr. Yen.
It involves removing the damaged disc
or discs and replacing them with spacers. Screws and plates are then inserted
in the spine to stabilize the spine and
facilitate fusion.
"We access the spine through the
front of the neck with a small incision,"
says Dr. Yen. "There is some minor risk
for nerve irritation and/or irritation to
the esophagus that can lead to difficulty swallowing, but otherwise the risk
involved for this procedure is low."

PHOTO BY JACKSON SMITH PHOTOGRAPHY

he pain was debilitating. It
radiated from her neck to
her shoulders and into both
arms. For 69-year-old Elsa
Kiser, even lifting a stack of papers was
unbearable at times. "The feeling is hard
to describe," says Kiser. "I had numbness
in both of my arms. It was like I was carrying a heavy load. You could see it in
my face that I wasn't doing well. I had to
force myself to stay motivated."
The painful symptoms began affecting Kiser's quality of life. A retired
schoolteacher, she struggled through
the day-to-day demands of her parttime work as a parent liaison for
Augusta County Public Schools. But last
December, she finally sought relief and
made an appointment at the University
of Virginia Spine Center.
"Ms. Kiser was a typical case of herniated disc," says UVA Health System
neurosurgeon Chun-Po Yen, MD. "This
is a degenerative condition, so it's quite
common among our aging population.
It happens to about 3 million patients
each year. Most, like Ms. Kiser, experience nerve irritation that causes pain
and weakness in the neck and arms. But
in some cases, a patient also may have

BY HOLLY FORD
Vim & Vigor - Summer 2019 - UVA

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