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Surgical Treatment of Degenerative Spinal Disease

Ernestine Davidson
After surgery to relieve pressure on her spine, Ernestine Davidson, now pain free and mobile, is back managing her employer's estate.

Ernestine Davidson doesn’t know the meaning of rest.

Since growing up on a Mississippi farm, she’s moved through life with a built-in sense of perseverance. The 68-year-old, who is accustomed to hard work, has become a self-starter and successful businesswoman.

Her first venture was a business that provided in-home care for the elderly. It was through that work that she met her current employer, a Dayton-area professional who needed someone to run the day-to-day operations at his large estate. He found what he was looking for in Ernestine, and today, 20 years later, she’s still going strong. It’s a lot of work and
responsibility that Davidson handles with professionalism and determination.

But, along with her backbone (a good thing), Ernestine has backbone problems (not so good). When Ernestine began experiencing excruciating back pain last November, she felt as if her world had stopped. Still, the pain – which made it impossible to walk or sit for periods of time – was a familiar one. She had suffered it nine years earlier when aging and arthritis had gotten the better of two vertebrae. That time, she underwent spinal surgery at Miami Valley  Hospital and was amazed at how quickly she got back to normal.

That’s why Ernestine didn’t hesitate when the pain returned. She knew surgery was her only hope, so she called the surgeon she knew could help – Marcos Amongero, MD, at the Orthopedic institute of Dayton.

The Root of the Problem

Ernestine has degenerative spinal disease, which results in the loss of normal structure and function in the spine due to pressure on the spinal cord and nerve roots. Two separate issues created the pressure.

First, a gradual overgrowth of her facet joints, which link the bones of the spine, had caused her to develop spinal stenosis, or narrowing of the spinal canal.

And secondly, she had a large herniated disk between two of her vertebrae. The spinal cord is made up of disks that resemble a soft jelly donut. Severe pain and restricted mobility result when that disk’s soft center gets pushed out of place and its nucleus bulges into the spinal canal.

Dr. Amongero HS
Marcos Amongero, MD

“It’s one of the most painful things you can go through,” Ernestine says. “But the amazing thing is how soon you heal after surgery.” In January, she underwent a three-hour surgery where Dr. Amongero decompressed the nerves and stabilized her spine. Five days later, she returned home on the road to recovery.

Cases like Ernestine’s can cause people to have a misperception of spinal surgery. Many think that if people are going in for a second surgery, it means the first one didn’t work. But that isn’t necessarily the case.

“Your spine is made up of multiple bones,” explains Dr. Amongero, a clinical assistant professor atWright State University Boonshoft School of Medicine. “You can operate on one segment, but over time, other segments may deteriorate as well. The reason people may need surgery again is that they have a new area on the spine that is giving them trouble.”

The Effects of Genetics and Time

Degenerative spinal disease is a general term that refers to any disease of the spinal column. It can result from the aging process or from wear and tear on the bones and soft tissues of the spine. Some people are more predisposed to it than others.

Degenerative spinal disease includes herniated disks, bone spurs or thickened ligaments, all of which create pressure on the nerves in the spine.

Many patients who have mild conditions can be treated non-surgically with physical therapy, medical injections, decompression therapy or anti-inflammatory medications.

Spinal surgery is reserved for more serious cases where the disease has had a severe impact upon the patient’s quality of life. Only about one out of every 10 office patients seen by Dr. Amongero requires surgery.

Similar Surgery, Different Environment

Ernestine knew her only option would be surgery, and while that came as no surprise to her, the stay at MVH did. Ernestine was one of the first spinal surgery patients to experience the hospital’s new Orthopedic Joint and Spine Center. She’s been talking about it ever since.

“The facility is absolutely fine, and the service I received was unbelievably good,” Ernestine said. “If I rang the call button, they were right there to help me.”

The center, located inside the hospital’s new patient tower, has also transformed the way orthopedic surgeons like Dr. Amongero are able to practice medicine. The new tower offers a floor dedicated to spinal surgery patients. Now patients are cared for by nurses and physical therapists accustomed to treating the same condition.

Such continuity of care enables staff to know much more quickly if a patient is feeling or experiencing something abnormal. Meanwhile, private patient rooms provide the environment that is needed to help the healing process. The room’s large windows, for instance, help patient’s stay on a natural day-and-night cycle, which is something that can be a challenge for patients taking narcotics to handle pain, Dr. Amongero says.

Ernestine’s healing went just as planned and couldn’t have come at a better time. She started feeling back to normal just as spring arrived. As an avid gardener, that meant she was able to put her energy back into caring for her flowers and vegetable plants and managing her employer’s estate.

Now Ernestine focuses on the backbone needed to get the job done . . . not the one that held her back.

Learn more about the Orthopedic Spine Center at MVH.