The Disc Doctor

Surgical treatment of disc herniation relieves pain

In our high-tech world there are many types of discs—floppy discs, compact discs, and DVDs. But the most essential discs are the natural ones—those in the human spine, made of cartilage, which serve as flexible and strong connections between the individual bones known as vertebrae.

The discs in the neck and back are vulnerable to injury as well as a natural aging process (degenerative disc disease). “Herniated discs can happen to very young people and without trauma or a major injury. Later in life, discs can also become worn or arthritic. Arthritis in the spine results in spinal stenosis.

The spinal canal becomes narrowed, pinching nerves,” explains spine surgeon Dr. Ira Fedder of St. Joseph’s Orthopaedic Institute.

Disc problems can cause life-altering leg or arm symptoms (radiculopathy). These conditions can occur at any age, to anybody, fit or not, though sometimes there is a strong family history.

Many patients respond to physical therapy or medications. Others need surgery, which can offer excellent results and is performed by Dr. Fedder using the most expert pain control.

When Sarah Maddalone developed sciatica (leg pain) during her second pregnancy, both she and her OB/Gyn thought this common problem during pregnancy would resolve after she delivered her baby.

But Sarah’s pain became unusually severe as her pregnancy progressed.

“On a scale of one to ten, the pain was a ten. When I arrived at the hospital to deliver the baby, I had to use crutches to walk,” says Maddalone.

And her pain did not go away after she gave birth to a healthy baby girl. Less than two months later, she went to see Dr. Fedder. An MRI revealed that she had a herniated disc. He gave her two steroid shots that offered minor relief, but, ultimately, she needed a lumbar disctectomy.

“This is one of the most common spinal operations,” assures Fedder. “I make a very small incision that gives me access to her spinal canal, and then I remove the damaged pieces of the disc. This takes the pressure off the nerve and allows the nerve to heal. Most patients feel great relief; the body heals though we cannot repair the cartilage in the disc.”

Before Fedder closes the incision, he injects pain medication all around the incision site.

“That way, when the patient wakes up, there’s not that intense surgical pain that most patients experience,” he says.

“The results are outstanding. In the recovery room, I felt normal for the first time in months,” says Maddalone.

Just two and a half weeks following surgery, Maddalone was able to pick up her infant daughter independently for the first time. “I feel great. I can get back to living now!” she says.

Although Brian May feels just as good about his new lease on life, his surgery took four hours and was a more complex neck surgery, according to Fedder.

“He had cervical spinal stenosis, bone spurs and discs that were pushing on his spinal cord and nerves.”

“I was having severe neck and left arm pain,” recalls May, who began a new job, following a 30-year career on the Baltimore police force, just as his symptoms hit.

“To get the pressure off his nerves, I had to take out four discs and some of the bone,” says Fedder. “He was left with a series of gaps that I filled with spacers and a plate with screws.”

For spacers, Fedder uses a choice of materials that range from bone to plastic and titanium. The plate and screws hold the spacers and bones together.

“The process of doing the fusion stimulates the growth of bone,” he says. Fedder performs the surgery through the front of the patient’s neck, which takes particular skill, but results in significantly less discomfort for the patient.

“I never had any neck pain afterwards,” says May. “I work out five days a week now and golf. There’ve been no limitations. I was pretty impressed with Dr. Fedder.”