"Lying
flat on back; looking up;
reaching up; driving; any activity requiring arms
to be lifted up
A Surgery
That Should Not Be Done!
In
November, 2005, at age 41, Bradley and his wife Donna traveled from Southern
California to Straubing, Germany so Bradley could have a very unique,
seemingly impossible surgery. Suffering from the effects of a 3-level
laminectomy 17 years earlier, his upper cervical spine had collapsed
into 'swan neck.'
The discs in his lower cervical spine had become severely degenerated.
The constant burning, pain and numbness in his shoulders arms and hands
were
making it impossible for him to continue his career as a professional
jazz musician.
Bradley
been to 1/2 a dozen leading spine specialists, both neuro and orthopedic
surgeons
and the news was not good. The surgical recommendation that
he kept getting was for BOTH anterior and posterior surgeries:
1.
Anterior procedure
with plate instrumentation and interbody fusion from C2-T1, including
corpectomy C6.
2.
Posterior procedure
which would include segmental instrumeted stabilization from the
occiput (C0) to T1.
What
would it mean to be fused from the skull all the way to the thoracic
spine? It would mean that even a successful surgery leaves the patient
with serious limitations. The angle of the head relative to the shoulders
is fixed. Every movement of the head must also involve the shoulders.
You can't duck your head to get in the car. You can't tip your head forward
to sip from a full glass. You can't look up without bending back. You
can't look down without bending forward. The angles are fixed in a position
that is a compromise. What one angle works best for most activities?
If the angle is fixed incorrectly, walking becomes diffiuclt as the only
way to compensate for the angles is to change the orientation of your
entire upper body.
Bradley
was warned against the prodecure that Dr. Bertagnoli proposed. The odontoid
plate fusion from C1 to C4 was not a procedure that could be done in
the US. The idea of a 3-level ADR from C4 to C7 in conjunction with the
fusion above was considered to be unreasonable. While Bradley and Donna
were being frightened away from the overseas options, I was going to
the doctors and getting details about what their reservations were. Over
the span of many months with several spine conferences and several of
my trips to Germany, I was getting answers for all of the real issues
that were raised. (I guess this is the GPN version of shuttle
diplomacy.) Without this, I don't think that Bradley and Donna
would have had the information they needed to make an informed decision,
nor the confidence to proceed against the warnings of all their local
surgeons. Of all the work that I've done for so many spine patients
through the years, what I was able to do for Bradley and Donna ranks
among my proudest achievements.
updated
6/15/08 Mark Mintzer
One
of the things that is absolutely beautiful about this solution is that
whatever the future brings, so many options are preserved. The option
of posterior fusion if it is needed in the future is completely unhindered
by what
was done.
This solution involves NO posterior surgery. If fusion from C0 to T1
is needed in the future, it can still be done.
Many of the local surgeons
had objected to the high risk of infection associated with oral access.
Dr.
Bertagnoli has perfected the procedure of implanting the odontoid plate
all the
way up to C1 without going through the mouth, but instead operating
through a small incision lower in the neck. The special tools that he's
invented in order to make this possible are engineering masterpieces.
After
a very difficult surgical ordeal in Germany, Bradley and Donna returned
to Southern California
to begin what has been a wonderful recovery. He played his first gig
in early January. On March 5th, he played his first full concert! By
June, he was back to golf and tennis. What an amazing transformation!
Updated 6/15/08
Mark Mintzer
Catalina Jazz
Club Hollywood California, June 7,
2006
The last time I saw Bradley and
Donna was in Straubing last December. They'd made it through
their ordeal and were headed home a few short weeks after Bradley's
surgery. I was excited to see them and especially pleased to
see Bradley playing. He did play a concert (just a few songs)
for the hospital staff in Germany, but I could see how difficult
it was for him.
Seeing him last night... he looked
great; so much different than before or just after his surgery.
We talked about playing tennis together and he's golfing almost
every day now!
Of all the surgeries I've seen,
his was (and is) the most incredible... absolutely one of a kind.
I believe that he's a walking miracle!
Spaghettini
Grill
and Jazz Club
Seal Beach, California, Nov 14, 2008
It
had been a couple of years since I'd seen Bradley and Donna.
I'd missed so many of his local events because of my trips with
clients for their surgeries. I was so pleased that he was playing
locally on Friday. Diane and I went early to make sure we'd get
good seats. What a wonderful evening. It took me a while to quit
marveling at how normal his movement was. He was able to jump
around with a constant smile on his face!
Diane
hadn't seen them since Germany. "It's
great to see Bradley having a good time," she said.
We
got to chat for quite a while. He's still golfing frequently
and playing tennis. Next week, he's 3 years post-op. I don't
think that any of us would have imagined this kind of success.
