Advertisement Nothing helped him — even surgery to remove a ruptured disc. Mahlum said the pain was so bad that he backed out of bed and needed help to get dressed and tie his own shoes.
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Gundersen Lutheran neurosurgeon Dr. Drew Sullivan performs cervical and lumbar disc arthroplasty which can relieve patient’s back pain.
PETER THOMSON photo |
“It was just easier to sleep in a chair,” Mahlum said. “I really hurt at night. I just learned to live with it.”
A degenerated disc in Mahlum’s lumbar vertebrae was causing chronic back pain, which often was unbearable.
Mahlum was referred to Dr. Drew Sullivan, a Gundersen Lutheran Medical Center neurosurgeon who was trained and ready to perform cervical and lumbar disc arthroplasty, a new surgical option to fusion that replaces the disc with an artificial device.
Physicians in Europe have been using disc arthroplasty for many years with success, Sullivan said, but both types of arthroplasty were only recently approved by the FDA for use in the United States.
Mahlum, whose disc had collapsed, had the first lumbar disc arthroplasty at Gundersen Lutheran on May 29, 2007.
“In lumbar vertebrae, you get about six to eight degrees of normal motion, but Chuck had zero motion prior to surgery and was on daily narcotics,” Sullivan said.
After surgery, Mahlum had eight degrees of motion and got off all narcotics. “This surgery is truly giving people back their quality of life,” Sullivan said.
Mahlum said he now has no back pain and can sit and move easily.
“Life is good. Life is the way it should be,” Mahlum said.
His fiancee, Lisa Heintz, said Mahlum used to walk bent over but now walks normally. “It has given him a new outlook on life,” Heintz said.
Because the height of the disc is restored during surgery, Mahlum said he grew 11/2 inches.
Sullivan said degenerative discs in the back and neck are common causes of severe pain for many patients.
“It's a hard problem to deal with and a very confusing medical problem that we don’t understand real well,” Sullivan said.
For years, the only surgical option for these patients was lumbar fusion or cervical fusion, but arthroplasty restores physiological function, he said.
When a patient has a lumbar or cervical disc replaced with the artificial device, the restored movement in the back or neck is virtually normal, Sullivan said.
Sue Ann Krause, 53, of Stoddard, Wis., was Sullivan’s first cervical disc arthroplasty patient.
Krause suffered from neck pain and a herniated disc. She also tried everything to get pain relief, but nothing worked. So she had surgery on Oct. 16, 2007.
“I jumped at the chance for the new surgery because I had been on narcotics and living in chronic pain for years,” Krause said. “The pain relief was immediate.”
She couldn’t move her neck hardly at all before surgery because she was in so much pain. Pushing a grocery cart, lifting and carrying things and just sitting were painful, she said.
“I stopped reading because I was in pain,” Krause said. “I read two books just last week.
“This surgery was a godsend,” she said. “I’m back to normal, free of pain. If I had the fusion surgery, I would have had more neck problems later.”
Sullivan said when a patient has fusion surgery, all of the load that joint used to carry is transferred to the adjacent joints.
“That causes those joints to deteriorate faster, potentially leading to more issues five to 10 years down the line,” Sullivan said. “Because we’re restoring function with arthroplasty, we’re not putting that additional pressure on the adjacent joints, which should mean a better future for patients.”
Unlike an artificial knee or hip, an artificial disc is expected to last the patient’s lifetime because there is less wear and tear, Sullivan said. “If a device does fail, we would then perform a fusion, but the patient will have had years and years of motion, sparing the adjacent disc,” he said.
Sullivan said not every patient with neck pain or low back pain is a candidate for arthroplasty. Most candidates for fusion or arthroplasty are younger, he said.
Nancy Gullickson, 46, of West Salem, Wis., had lived with lower back pain for eight to 10 years. She lifts a lot in her job as a food vendor and had a herniated disc that worsened.
Gullickson tried just about everything to get pain relief. “I couldn’t handle the pain anymore,” she said. “Sometimes I couldn’t go to work.”
She had lumbar disc arthroplasty on Nov. 13. The difference was immediate, she said.
“I slept the whole night that first night after surgery,” Gullickson said. “I was able to go back to work without pain. Do I believe it? I do believe it, because I can feel it.”
Sullivan said he has performed eight lumbar disc arthroplasty surgeries, and he and two other colleagues have done six cervical arthroplasty surgeries. He said European surgeons have done more than 20,000 surgeries over 20 years.
Dr. Mark Stevens, a Franciscan Skemp Healthcare neurosurgeon, said he performed arthroplasty with a different artificial disc about four years ago, but stopped. Stevens said he plans to offer the surgery again in the future.
Sullivan and Stevens said the barrier to arthroplasty is insurance coverage. Many insurance companies don’t cover it.
Gundersen Lutheran Health Plan is one of the first health plans to cover arthroplasty. Sullivan said arthroplasty is cost-effective because it can save the expense of medications and other therapies for many years.
“This is a very exciting surgery, and it’s extremely gratifying to see these patients get their life back,” Sullivan said.
Anatomy of the backbone
The vertebral column, also called the backbone, is made up of 33 vertebrae that are separated by spongy discs, which act as shock absorbers for the spine, and are classified into distinct areas:
Terry Rindfleisch can be reached at trindfleisch@lacrossetribune.com or (608) 791-8227.
