Arthritis and Spinal Disease: Nancy K. is a Spinal Champion


It is a pleasure to present the story of Nancy K. She is a sixty-three year old woman who was initially referred for complaints related to her neck. Nancy has had significant neck problems, off and on, for the past fifteen years, stemming back to a car accident she was in as a teenager.

She had pain, tingling and numbness in both arms, as well as a burning feeling in her neck and shoulders, and difficulty with her balance. The pain in her neck caused Nancy to have disabling headaches. The pain was so severe that it bothered her almost every day. She found some relief by lying on her side, but essentially was unable to sleep at night due to the pain. Sitting at the computer and even sitting while watching TV were intolerable.

Nancy does have a family history of spinal disease, and essentially presented with severe degenerative changes in her cervical spine. She had failed the typical conservative management strategies, including physical therapy, anti-inflammatory agents, massage, pain medications, and muscle relaxants. Her neck x-rays showed reasonable posture, however, she clearly
had severe degenerative changes at the C4/5, C5/6 and C6/7 disc spaces.

Her range of motion x-rays demonstrated that arthritis had essentially stiffened her spin and the grinding arthritis pain was forming bone spurs compressing both her spinal cord and the exiting nerve roots. Nancy’s MRI scan showed, similarly, that disc herniations were compressing her spinal cord.

Anterior-posterior and lateral post-surgery x-rays showing the fixation plate and the correction of the cervical curvature.

She had previously undergone a cervical fusion using donor bone and plate fixation, which failed to incorporate properly at the C4/5 and C6/7 levels.
Upon review of her studies, we recommended a revision surgery, which essentially consisted of removing the plate, using an osteotome to cut through the areas in which scar tissue had intermingled with the bony fusion, and performing the fusion a second time at C4/5 and C6/7 to accomplish a solid incorporation.

This would be the best way to restore her posture, alleviate her neck pain, and stabilize her spine in a permanent fashion. To perform the revision procedure, we utilized rh-BMP-2 (recombinant human bone morphogenetic protein) bone graft, which is essentially a human bone-forming protein produced by transfecting human chromosomes into Chinese hamster ovary (CHO) cells. The cells mass produce this protein, which is absolutely identical to native human protein and there is no risk of disease transmission. The protein was placed along with bone grafts and plate fixation to help promote healing.

At this point, in time, Nancy has not yet completely healed but is clearly on the road to recovery. Nancy K. has overcome adversity and suffered from years of disabling neck pain before finally finding a solution to her problems. The solution entailed a cervical fusion utilizing the state of the art rh-BMP-2 protein along with a very technically advanced plating system to stabilize her spine. We applaud Nancy’s efforts in dealing with spinal disease and wish her the best as her recovery progresses.

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