Surgery Provides Relief to Patient Experiencing Hand Numbness

THE DOCTOR

Dr. Donald G. Hope is one of the most experienced spinal surgeons in the Northern Virginia region. With a commitment to staying apprised of all neurosurgical advancements and palliative care for the spine, Dr. Hope and his staff are renowned for providing meaningful advice and prudent solutions for those suffering from back pain.

Dr. Hope’s primary goal is to get patients back to living their life, without pain and limitations. He only recommends surgery once all other reasonable treatments have been exhausted.

THE PATIENT

David Hertzberg is a recently-retired State Department foreign affairs analyst, writer, mentor, manager and political observer. Now he spends his time as an independent foreign affairs consultant and classical music YouTube archivist. He is an avid pianist who also enjoys building websites and managing an online record store.

David was referred to Dr. Hope after chiropractic and acupuncture treatments for symptoms including minor pain, numbness, and tingling in some of his fingers, began to worsen.

David knew that something “wasn’t right” for several years, but he wasn’t overly concerned until one morning in 2019 when he awoke to a numb right hand - perplexing and uncomfortable - that was compromising his dexterity. For a music lover, pianist, and avid computer enthusiast, this was incredibly disturbing. He realized immediately that the alternative treatments were not resolving the underlying problem and the condition was getting worse.

His left hand was still fine and although his dexterity was compromised, he never lost hand strength and he was determined to play the piano and use a computer keyboard for many years to come. He was hopeful that because he was in great shape and still had feeling in his left hand, it was not too late.

Although the idea of surgery was unnerving to David, his passion for music and the desire to have full use of both of his hands prompted him to schedule a meeting with Dr. Hope.

SUSPECTED SPINE ISSUE

As it turned out, a pinched nerve was the cause of David’s discomfort. It was his high tolerance for pain that allowed him to avoid surgery for as long as he did. Unfortunately, delaying surgery for an extended period of time decreases the chances of a positive surgical outcome; prolonged pressure on a nerve often leads to permanent nerve damage.

After meeting with Dr. Hope, David felt completely confident and at ease about the surgery ahead. David was very impressed that Dr. Hope took the time to review his complicated MRI and explain to him that due to the presence of large anterior bone spurs, the surgery could take up to twice the normal time to perform and might impact his rate of healing.

At first David was very reluctant to undergo spinal surgery, but his fears were assuaged by Hope's approach, manner, and honesty about the potential outcomes. Post surgery, David was surprised that all he needed for pain relief was Tylenol. He believes this is "a testimonial to Dr. Hope's skill.”

David relayed that Dr. Hope shared compassion and interest that he had not experienced with other medical professionals. Even while he was on vacation, Dr. Hope called David throughout his recovery to ensure he was on the path to recovery.

MYELOPATHY DIAGNOSIS AND SURGERY

After meeting with David, Dr. Hope diagnosed David’s issues as Myelopathy, an injury to the spinal cord due to severe compression. When any portion of the spinal cord becomes compressed or constricted, the resulting symptoms are known as myelopathy.

David’s symptoms, neck pain, arm discomfort and some numbness in his hands pointed to compression. Upon reviewing the MRI, imaging studies and an examination, Dr. Hope noted severe, significant compression was the culprit.

The challenge in treating David’s case was that if the spinal cord was severely compressed for too long, it might be too late for surgery to make a significant improvement. However, surgery would halt the progression of his pain and numbness which would continue to worsen without surgery. Although not painful, the numbness was clearly progressing.

Chiropractic treatment stopped working due to the severity of the compression. Although it can decompress some nerves, chiropractic treatment cannot repair damage to the central spinal cord.

Acupuncture can’t mechanically help spinal cord at all, but it can relieve a high degree of pain in some people with conditions such as pain and headaches.

Dr. Hope was very pleased that David’s alternative care providers realized that he needed a neurosurgeon. That is not always the case.

SURGERY AND BEYOND

After some discussion, David and Dr. Hope agreed that a Cervical Discectomy Surgery, also known as an Anterior Cervical Discectomy and Fusion (ACDF), was the best choice. It is less invasive, in most cases, and an easier and less painful recovery.

David’s case was unusual due to significant bony overgrowth; these bone spurs were part of his extreme spinal degeneration. Dr. Hope was able to reduce the spurs while avoiding any damage to his esophagus or vocal cords.

Dr. Hope was happy that post-surgery, David had no issues with hoarseness or swallowing. The best news was that David did get significant relief, which is always very rewarding for a Doctor to hear.

MORE ON CERVICAL DISCECTOMY

In a Cervical Discectomy, the vertebrae and discs are treated from the front of your neck using a 2-inch incision. During surgery, your windpipe, neck muscles, esophagus, and arteries are moved to the side to protect them while the discs are exposed for the surgery.

Once the damaged disc is identified with an X-ray, it is removed and replaced with a spacer, the pressure on the spinal nerves is eliminated. If present, bone spurs pressing on nerve roots or the spinal cord will be targeted for removal. The foramen (the canal through which the spinal nerve exits) may be enlarged to give your nerves more room inside the spinal canal.

Katherine ArensNovember 4, 2019