Elbow and Shoulder Pain Caused by Narrowing of Spine’s Cervical Discs: Jesse’s Story

The full-blown pain Jesse Manarang lived with for two years began gradually. It started in his early 40’s, with tingling and numbness in the index, middle and ring fingers of both hands.

As a dialysis tech at a north suburban hospital, Jesse had a physical job. After lifting patients for twelve hours, he came home exhausted and in pain.

His wife, Mildred, recalls, “Work, really everything, was so hard for him. He was getting depressed. He’d always been an athlete and loved basketball and lifting weights, but he couldn’t do his job or things he used to enjoy. He couldn’t drive our kids, both active in sports, to events. He couldn’t mow the lawn. He had to give up coaching our son’s football team. I was doing what he couldn’t and it was tough on all of us.” Jesse finally made an appointment with IBJI-Libertyville orthopedic specialist, Dr. Peter Thadani for elbow and shoulder pain. Dr. Thadani treated him conservatively using cortisone injections and epidurals, but when those failed to relieve the pain and Xrays of the shoulder showed narrowing of the spine’s cervical discs, he referred Jesse to his Libertyville colleague, spine specialist, Dr. Stanford Tack. After an MRI, Dr. Tack diagnosed Jesse with a degenerative joint disorder of the cervical spine. Says Dr. Tack, “Jesse’s condition was the result of genetics and weak disc structure. It wasn’t caused by trauma or injury, but there was clear early degeneration or herniation of several discs.”

Dr. Tack discussed the options with Jesse and Mildred, including a unique alternative – a hybrid surgical procedure combining disc replacement at one level and spinal fusion at another. While many surgeons perform disc replacement at a single level or spinal fusion, combining these approaches was unique and offered the best option for Jesse. Says Dr. Tack, “I performed for Jesse a C4 and C5 disc replacement and fusion for discs C6 and C7. Fusing the discs at both levels would have stressed adjacent levels of the spine and the intervening discs, increasing the chance of spinal breakdown and more surgery in the future. Doing these together really gave him an optimal outcome, allowing him to retain maximum mobility in his neck and upper back. ” Says Jesse, “Dr. Tack explained everything well. He would replace the cervical discs above the neck instead of fusing them, so I would experience no loss of mobility. He was going to fuse the lower discs only. I was ready and we had great trust in Dr. Tack’s ability.” Mildred remembers, “Dr. Tack said we’d know if the surgery was successful right away. Jesse would immediately feel better upon waking up and that was exactly what happened.”

Seeing Dr. Tack a few hours after surgery at Northwestern Lake Forest Hospital, Jesse waved both arms in the air and said, “I feel great. It’s magic!” Jesse’s healing required no rehab and in about six weeks, he was back to work. Within a few months, he had reclaimed his active life – biking, fishing, lifting weights and playing golf. Says Dr. Tack, “Jesse had a great outcome. The disc replacement gives him better mobility than total fusion would have, allowing flexion in his spine.” He adds, “FDA studies and recently published, long-term followup of cervical arthroplasty patients confirm the advantages of disc replacement over fusion including faster recovery and lower complication and reoperation rates.” Dr. Tack now routinely performs this hybrid procedure on an outpatient basis in a surgery center setting.