Tina Wright has a lot going on in her life. She’s a wife, mom of a teenage daughter, registered medical assistant and in nursing school to pursue her dream of becoming a nurse in the neurology field. So, the Delta, Mo., resident knew she could no longer live with the chronic neck pain that had been bothering her for years.
“I’m not really sure what happened to my neck, but I started having pain about three to four years ago,” says Tina, 34. “I worked in a neurosurgeon’s office at the time, and when it was decided that I might need surgery, my former employer didn’t feel comfortable actually doing the surgery, so he referred me to Dr. Wright, who had also done neck surgery on my dad.”
Neill Wright, MD, the Washington University Herbert Lourie Professor of Neurological Surgery and a neurosurgeon at Barnes-Jewish Hospital and Barnes-Jewish West County Hospital, was happy to see Tina and thought he could provide her with some relief. (Note: Dr. Wright and Tina Wright are not related).
While some patients do experience neck pain after an injury, fall or car accident, many develop symptoms just as a result of wear and tear on their bodies, Dr. Wright says.
“We are the first animal to walk upright, and the spine isn’t perfectly designed for this,” he says. “Our neck is essentially responsible for carrying our bowling ball-sized head and allowing all of the movement of the head relative to the body. That combination of movement and carrying the weight of our head leads to progressive degeneration of the discs and joints of the neck over time. Injuries speed up this process (whether that was playing contact sports, having car accidents, having an unusual occupation that requires unusual head positioning), but the spine can wear out even without any known insults.”
Tina knew that she could not live with the ongoing pain and how it was affecting her life. She also was aware that being a nursing student and ultimately a nurse caring for patients would be even more difficult if she didn’t address the chronic neck pain.
“I first met with Dr. Wright at Barnes-Jewish West County Hospital for a consultation. He wanted to try physical therapy and another steroid injection (she had a previous one at home),” Tina says. “Dr. Wright was very focused on pinpointing the problem before he determined if I needed surgery.
“I was nervous because I have small arteries, but after talking to everyone, my fears were put to rest and I had surgery March 13 of this year, and the experience was amazing,” she says.
Tina had compression of a nerve in her neck from a bulging disc.
“Discs act like cushions between the bones in the neck, but when they get damaged, they can bulge out and compress either the spinal cord (causing weakness, numbness, clumsiness) or the nerves as they leave the spinal cord to go into the arms (causing pain, weakness, numbness, or any combination of those symptoms),” Dr. Wright says.
Surgery to relieve those complaints is typically done from the front (anterior) of the neck (cervical), working between the throat and the muscles on the side of the neck, to remove the damaged disc and any associated bone spurs (diskectomy), he adds.
“We then need to put something in place of the disc. For patients with neck pain, we typically fuse the level with a piece of synthetic bone and a metal plate attached to the spine, like in Mrs. Wright’s case,” Dr. Wright says. “For patients with only arm complaints, we often place an artificial disc instead of a fusion. Both of these surgeries (fusion or an artificial disc) take about an hour, with an overnight stay in the hospital.
As a first-time patient at Barnes-Jewish West County Hospital, Tina says everyone at the hospital she came in contact with made her feel comfortable and confident that she had made the right choice.
“I really liked the size of the hospital and how everyone was so caring,” she says. “The nurses were amazing, and when they found out I was in nursing school, they’d often stay and even quiz me. I could not have had a better experience and I know I made the right decision for me.”
It’s important to know that the majority of patients with neck issues do not need surgery, Dr. Wright says.
“Of the patients I see in clinic, more than 80 percent are able to get past their pain, numbness or weakness with conservative measures,” he says.
Dr. Wright normally starts his patients’ treatments with physical therapy for four to six weeks, and sometimes tries epidural steroid injections, as well. He also tries anti-inflammatory medications and muscle relaxers.
“Only when these conservative treatments do not provide relief do we typically move on to surgery. There are some exceptions, though,” he says. “If a patient has compression of the spinal cord, and symptoms or exam findings suggest that the spinal cord isn’t working properly (such as weakness of the arms and hands, clumsiness of the hands or clumsiness of walking), we often move directly to surgery instead of trying conservative measures, due to the risks of permanent and irreversible damage to the spinal cord.”
Several months after her surgery, Tina is doing well and is expected to make an “excellent” recovery with complete or near-complete resolutions of her chronic neck pain.
“It is possible, however, for her to develop pains from another level of her neck in the future. This happens in about 10 percent to 15 percent of patients over the next few decades,” Dr. Wright says. “That is one reason we try to place artificial discs rather than doing a fusion, as artificial discs have lower rates of adjacent segment (next level) disease compared to fusions. But for those with significant neck pain, a fusion is a better option.”
Tina says she would definitely recommend Dr. Wright and Barnes-Jewish West County Hospital to others.
“I was trying to avoid surgery because of my age, but I could not live with the pain any longer,” she says. “Dr. Wright has a wonderful bedside manner, and I could not have asked for a better surgeon. His office staff is also great, and they always greet you with a smile.”
Dr. Wright has been performing surgeries like Tina had for the past three years at Barnes-Jewish West County Hospital.
“My patients have really appreciated the kind and compassionate care they receive throughout their entire stay here,” he says. “They have commented on the calm and healing atmosphere on the patient floors, the quality of the staff and the ease and convenience of parking.”
Dr. Wright sees patients at Barnes-Jewish West County Hospital every Wednesday and Thursday in clinics and performs surgeries on Tuesdays. Once the replacement hospital is completed in 2019, he hopes to add a second day of surgeries each week.
Washington University physicians treat spine injuries and disorders both surgically and non-surgically, call 314-542- 9378 (WEST) or request a call for an appointment online.
To refer a patient, physicians can call the Washington University department of neurosurgery at 314-362-3570.