Sutter Institute for Medical Research 2008 Annual Report

Artificial Disc Puts Skier Back on the Slopes
Rael was putting a piece of stone on a high shelf when
she felt a twinge in her neck. An active 40-something
woman who loved to ski, Rael was used to strained
muscles and didn’t think much about the soreness in
her neck that evening. When the pain increased instead
of going away, Rael thought she had pinched a nerve
and went to see her doctor, who sent her to a physical
therapist.
“Physical therapy only made the pain worse,” said Rael.
“I also practiced breathing, relaxation and focusing
exercises — anything I thought might help me deal with
the pain.”
In spite of everything she tried, the pain persisted and
her once-active life slowed to an agonizing crawl. Three
months after that first twinge, Rael underwent an MRI.
The scan revealed a bulging disc pressing directly
against the nerve roots of her spinal cord. Though glad
to understand what was causing the pain, Rael also
knew the most likely medical treatment would be to
remove the disc and fuse her neck vertebrae, which
would increase the risks of disease at other levels and
potentially mean the end of skiing and many other
activities she loved.
That December, Rael went to neurosurgeon Cully Cobb,
M.D., and immediately knew she’d found the right
patient-doctor fit. “Dr. Cobb doesn’t think of surgery as
the first option, which made me feel good,” said Rael,
“and he really understood how important mobility
is to me. When he told me about the possibility of
volunteering to be part of a study for a new artificial
cervical disc, I knew he wouldn’t have suggested it
unless he felt confident that it was the best solution for
me. Even though I would be one of the first patients in
the U.S. to get the device, Dr. Cobb, research coordinator
Kimberly Olsen-Wilson and the device manufacturer
were so thorough about making sure I was a good
candidate that I never felt apprehensive.”
Getting through the eight months it took to lay the
groundwork for surgery proved to be much more
difficult than the surgery. Rael went into surgery
at eleven, woke up in recovery around two, and
was standing up and walking by four o’clock. She
went home the following morning and saw a daily
“I feel as
though I was
never injured.”
improvement over the next three weeks. The mental
exercises that helped her manage the pre-surgery pain
also enabled Rael to manage the post-surgery pain with
nothing more than ibuprofen.
“I hit a wall at three weeks,” Rael said, “but Dr. Cobb
said that was part of the natural healing process my
body was going through, so I just kept pushing through.
By December I felt ready to ski again, but the doctors
made me wait six months to ensure the new disc was
firmly in place.” By the spring, six months after the
surgery, Rael felt she had regained her pre-injury
strength and stamina. The snow was gone for the year,
but she was ready to go the following season.
“I feel as though I was never injured,” she said, adding,
“I have no loss of mobility, no pain, no lingering issues
— none at all.”
The five-year study requires Rael to get a yearly CT scan
and X-rays to track her long-term healing, but it’s a sure
bet that she’ll schedule those appointments before or
after the ski season.