September 30, 2022 by John Fernandez
Spine Surgeries at Miami Neuroscience Institute Save Nurse’s Mobility, and the Career She Loves
Ignoring persistent back pain is not a good idea, because you never know if it’s your body’s signal that something serious is causing your discomfort.
That was the case with Melanie Santos, R.N., who tried to tough it out when she experienced back pain, leg pain and numbness in her shoulder. Suddenly unable to walk one day, she ended up in Baptist Hospital’s Emergency Department, where she learned her long-term mobility could be at risk.
Thanks to two procedures with neurosurgeon Jobyna Whiting, M.D., the director of degenerative spine surgery at Miami Neuroscience Institute, Ms. Santos is now back on her feet, back to the job she loves, and more active than ever.
(Watch video: Hear from patient Melanie Santos, R.N., and neurosurgeon Jobyna Whiting, M.D., the director of degenerative spine surgery at Miami Neuroscience Institute, as they recount Ms. Santos’ life-saving surgeries. Video by Carol Higgins.)
A bedside nurse for 20 years, Ms. Santos figured her lower back and leg problems were caused by the physical exertion of tending to patients. She thought it was just muscle fatigue or perhaps sciatica, a common nerve problem usually treated with self-care. She says she kept going by taking over-the-counter anti-inflammatory medicine and resting, but the pain was becoming debilitating.
On one particularly excruciating day, her daughter and co-workers insisted she go to the Emergency Department. That’s when she learned she had a herniated disc in the lumbar area of her back — but that’s not all.
“While I was in the emergency room, I mentioned to the emergency room doctor that my right shoulder had been getting numb for the past couple of months,” Ms. Santos said. Concerned, the doctor decided to do a full scan of her spine, only to discover another herniated disc, this time in her neck.
“It was actually pushing on the spinal cord, which is basically the worst-case scenario. The spinal cord is very high-price real estate, if you want to think of it that way. It’s a small area and it controls a whole lot of the body. And so it doesn’t take a lot of pressure to start causing problems,” Dr. Whiting said. “We really needed to prioritize the neck just because the danger was so real.”
Ms. Santos was admitted immediately. Dr. Whiting recommended an anterior cervical discectomy and fusion of two vertebra in the neck. Although it would not help with Ms. Santos’ lower back and leg pain, the procedure would take the pressure off her spinal cord and stabilize the situation.
“It was pretty serious,” Dr. Whiting said. “She was expecting to maybe hear something about what we could do for her back. And now I’m telling her you have pressure on your spinal cord and if you don’t do something about it, then you’re really at risk of losing your ability to use your hands, losing your ability to use your legs appropriately, maybe even going so far as losing your ability to control your bowel and bladder.
“The issue is that it’s your spinal cord — and the spinal cord, especially up here in the neck, really controls everything. And so if you have a spinal cord that’s at danger, you’re really risking losing all your ability to move your body independently.”
Two days later, using an incision through the front of the neck, Dr. Whiting carefully removed the ruptured disc of spongy material that cushions the vertebra, peeling it away from the spinal cord. She inserted material to fill the space, then used a titanium plate and two small screws to hold the vertebra together.
Then, weeks later, when Ms. Santos healed from the neck surgery, Dr. Whiting performed a similar procedure to decompress the nerve in Ms. Santos’ lower back after determining that less invasive remedies, such as epidural injections and physical therapy, would not resolve the problem. She used screws, rods and a bone graft to fuse the vertebra, solving the instability that had severely pinched a nerve and the eliminating the possibility of further pain.
Fully recovered, Ms. Santos is enormously grateful for the outstanding care she received from Dr. Whiting and Miami Neuroscience Institute. She has been able to travel, exercise, and return to work. She tries not to think about what might have happened if she hadn’t sought care and discovered the problem in her neck.
“I would probably be disabled, unable to work, unable to live the life that I want, do the job that I love, which is nursing, and to enjoy my family,” she says. “My advice to people who are thinking of self-diagnosing their neck and back pain is to go get a consultation. You’ve got to get an expert, professional opinion.”
Dr. Whiting said many people dismiss their discomforts as routine aches and pains. They don’t bother discussing them with a physician, when they should.
“I think that there are a lot of people who basically hold on to pain a lot longer than they have to because they just assume it can’t be anything serious or meaningful,” she said. “Basically, if you’ve had persistent back, leg or arm pain that’s been going on for more than a week or so, and it is not responding to your normal rest or ibuprofen or things like that, I think it’s very reasonable to talk to your doctor about it.”