William Beaumont Army Medical Center’s Neurology Clinic is taking a different approach to beneficiaries suffering from neck pain.
Neurosurgeons at the clinic are combating cervical disc disease, a common condition among the military population, by performing cervical disc arthroplasty (CDA), or disc replacement surgery, on beneficiaries who may be experiencing the painful effects of the wear-and-tear condition.
“I believe in the procedure because it promotes faster recovery, and reduces the chance of degenerating the disc above and below,” said Dr. Pedro Caram Sr., senior neurosurgeon, WBAMC.
The joint replacement surgery involves replacing damaged cervical disc(s) with prosthetic disc(s). The treatment may provide relief for patients by decompressing or relieving pressure on the spinal cord or nerves and restoring stability and alignment.
Other symptoms from a degenerative disc may include increased pain in shoulders, arms and in some cases may even lead to migraines.
“I’ve treated people with what they thought were migraines but really their necks were causing the problem,” said Caram, a native of Houston. “(Staff) examines patients very carefully in the clinic. I don’t let them get away without an exam and look to find out what they’ve done from a conservative (management) standpoint, find out if they’ve had any trauma and go over medications.”
The initial examination also includes a look over pain history, spasms and a test of strength, the results of which alarms most patients.
“(Caram) proved I was a lot weaker strength-wise on my first visit,” said 1st Sgt. Joseph Phillips, C Company first sergeant, 1st Battalion, 6th Infantry Regiment, 2nd Brigade Combat Team, 1st Armored Division. “The pain limited my ability to do pushups, sit-ups, wear body armor for long durations, it would hurt.”
When he began noticing a consistent pain in his neck and shoulders, Phillips, a native of Prince Frederic, Maryland, began seeking medical attention and was eventually referred to the Neurology Clinic. Phillips was also suffering from tingling of the hands, numbness of the arms and the aforementioned loss of strength.
“It was pretty consistent, everyday all day like a five or six (on a pain scale of one to 10),” said Phillips.
After a visit with Caram, Phillips, an 18-year Calvary Scout veteran, was recommended for surgery.
Caram favors CDA over the traditional treatments which may lead to delayed recovery.
In 2007, the Food and Drug Administration approved CDA as an option for treating cervical disease. In 2009, Caram spearheaded the procedure at WBAMC and has since performed dozens of surgeries.
According to an article Caram and colleagues published in the Journal of Surgical Orthopaedic Advances, in a study of 34 single-level CDA patients, 30 returned to duty with an average 8.5 weeks of recovery time. In a multilevel cervical disc disease study with a hybrid approach to treating the disease, meaning CDA and cervical spinal fusion applied, out of 30 patients, 24 were able to return to active duty with an average 15.6 weeks of recovery.
For Phillips, a 37-year-old father of two, results were immediate following his multilevel hybrid cervical disc arthroplasty.
“I had no more issues, no more tingling and my strength came back immediately,” said Phillips.
Prior to the surgery, Phillips would struggle to throw a ball and play with his two daughters, said Phillips. Six weeks into his post-operation recovery, Phillips is able to participate in more physical activities at home than before.
“It proves that us older guys should have got fixed a lot sooner, we should have paid a little more attention to our bodies over the last 18 years,” said Phillips.
“(Phillips) will be fit for duty. That’s what our goal is: to make them fit for duty,” said Caram.
Author: Marcy Sanchez – WBAMC / DVIDS