Patient regains pain-free neck movement after consenting to receive investigational artificial disc implant

The pain in Jill McCarty's upper back, neck, and left arm quickly went from annoying to excruciating, clamping down unexpectedly and progressing with frightening momentum.

McCarty, 43, a science and social studies teacher at Mediapolis Middle School in Mediapolis, Iowa, had never had major back or neck problems. She still can't pinpoint the exact cause of the injury, which turned out to be a C7 disc herniation. "I think it was the culmination of an active lifestyle, including farm work when I was younger, capped by a fall down some stairs in April. I fell flat and it really jarred me."

On Aug. 27, 2003, McCarty began experiencing muscle twitches in her left arm. "The area between my shoulder blades felt like something was out of place and was poking me," she said. "It got worse during the night. My whole left arm ached." She went to her doctor, who prescribed pain medication and muscle relaxants and said to come back the next day if there was little or no improvement.

Instead, after the pain became more than she could manage, McCarty wound up in the emergency room of the Henry County Health Center in Mt. Pleasant that night. After a battery of tests, including X-rays and magnetic resonance imaging, Thomas Bainbridge, M.D. (a 1987 graduate of the University of Iowa Roy J. and Lucille A. Carver College of Medicine, where he also completed his residency and a fellowship), referred her to UI Hospitals and Clinics.

Vincent Traynelis, M.D., professor in the Department of Neurosurgery, was part of a UI team that evaluated McCarty. Traynelis, who is participating in an FDA-approved trial involving the PRESTIGE™ Artificial Cervical Disc, an implant developed by a Memphis, Tennessee-based medical technology company, believed she was an ideal candidate for the investigational prosthesis.

"Mrs. McCarty is young and had only one level of disc disease. I felt the artificial cervical disc would allow her to enjoy normal spinal motion after surgery," Traynelis said.

The prosthesis closely matches the function of a normal spinal disc space and potentially provides patients with more normal neck movements following surgery. It consists of two metallic components and is affixed to the vertebral bodies with screws. The two components are designed to act as a pivot point, which allows the spinal segment to achieve a range of motion.

McCarty said she experienced immediate relief after voluntarily undergoing the procedure (she chose the new approach over the standard surgery, anterior cervical disc fusion), and has had no further pain in the weeks since. "I went home the very next day. I was able to leave without a cervical collar and was given very few restrictions in activities. Those restrictions were lifted quickly and I am again able to do what I want."

Traynelis said McCarty should have no more back, neck, or arm pain associated with the injury.

There are several restrictions to enrollment in the artificial disc study. Among them, participants may not have had any previous cervical spine surgery and must need surgical intervention at only one level.

Pivotal decision

Classroom teahing is a joy again for Jill McCarty, who overcame a C7 disc herniation. The condition even became instructive when Trista Clark, a UI research asistant, created a PowerPoint CD so McCarty could show images of the artificial disc and what the operation was like. "My students thought it was really cool," McCarty said.

For more information, patients may call UI Health Access at 800-777-8442, while physicians may call UI Consult. Please mention having seen this article in PACEMAKER, request the neurosurgery service, and specify Dr. Vincent Traynelis by name. Alternatively, Traynelis can be called directly at 319-356-2774.

"After hearing how much faster and easier they expected my recovery to be with the artificial cervical disc, I definitely wanted to participate and I have not regretted for one moment having the surgery."

--Jill McCarty