In the early 1990s, I had just had my first MRI scan, and as a medical practitioner I was allowed into the radiology office. On the screen were images of a cervical spine showing considerable problems. "Whose spine is that?" I asked the radiologist, who replied, "I’m afraid, sir, it’s yours." Aside from neck and arm pain, I was healthy and fit and only in my thirties—and amazed to see several discs pushing into my cervical spinal cord.
A local neurosurgeon said I needed open surgery from the front of the neck, displacing the windpipe, gullet, thyroid, and major blood vessels and nerves, to remove the prolapsed discs and replace them with bone from my pelvis. He explained the associated risks of significant minor and major side effects—including the possibility of paralysis from the neck down.
My approach to patients had always been to avoid risky treatments when possible, and I was not going to be any more cavalier with myself. The neurosurgeon somewhat reluctantly agreed to try to avoid surgery but insisted that I reduce my workload. Although this was not easy, I resolved to slow down and get away on holiday more often, and my condition settled down somewhat. But the neck pain became intractable in 2004, and I began to lose the use of my dominant left arm, so I looked into minimally invasive spinal surgery (MISS). A specialist in Manchester told me that clinicians in the UK had some experience in MISS for the lumbar spine but little with the cervical spine. He mentioned a center of excellence in South Korea led by Dr. Sang Ho Lee, at Wooridul Spine Hospital in Seoul.
I contacted Dr. Lee’s team and found them extremely helpful. So I flew to Korea, where I was met at Incheon International Airport by the hospital’s senior administrator for overseas patients, and soon underwent detailed examinations with the most advanced imaging technology I had ever seen. Immediately afterward, Dr. Lee gave me some bad and good news. He said that my extensive disc problems and spinal stenosis were too advanced for MISS, and he advised open surgery, but with the reassurance of much lesser side effects than were previously suggested.
The next day I had open surgery for discectomies at levels C4/5/6, with cadaver bone allografts and titanium steel plate-and-screw fixation to aid fusion in my neck. I expected a lot of pain afterward, but the pain control was excellent. I had no complications whatsoever, the nursing care was great, the conditions were comfortable, and the food was good. When the dressings came off, the scar was small, clean, and hardly visible. I was elated at the already positive results: arm usage returning, much less arm pain, and less numbness.
Dr. Lee confirmed that all had gone well. Physiotherapy was provided, with exercises and postural recommendations to be continued after my discharge. I went home in a neck collar and much improved, and I eventually got back to part-time work. Although followup visits to Korea in 2005 and 2006 showed some stenosis and disc narrowing at other cervical levels, I was delighted to see that the treated levels were fused and stable.
But in 2007 a new problem emerged: I started to experience chest pains. Cardiovascular disease was excluded as the cause, and the pain appeared to be referred from my thoracic spine. I went promptly to Dr. Lee at WSH, where investigation confirmed prolapsed thoracic discs. This time—probably because I did not delay—I could be treated by MISS.
I underwent discectomies at the T8/9 and T4/5 levels under local anesthesia. A team of radiologists and neurosurgeons removed the discs using advanced imaging techniques and widened the bony spaces that were trapping nerves. The alternative could have been as drastic as opening my chest, bypassing the heart, and collapsing the lungs to access the thoracic spine—with potentially very serious side effects. But with MISS, I was able to leave WSH in a chest brace the next day.
I am very pleased with the success of my treatment, as most of my spine is much more stable, the chest pain is almost completely gone, and I have use and feeling in both arms. I have been told to take it very easy for the future, and I hope to avoid further surgery by following the WSH team’s advice—but should other parts of my poor spine start to flare up, I will have no hesitation in returning to WSH. I would recommend their expertise and care to anyone with spinal problems.
Last updated on 28 January 2016
Before Leaving the Hospital: Get All the Paperwork
Impatient to be gone, and often suffering the woozy side effects of surgery and post-operative pharmaceuticals, patients too often find themselves back at home later, missing important documents that could have more easily been obtained on site. So before you hightail it out of your hospital or clinic, be sure that you have all of your important documents.
Generally, larger hospitals provide complete medical documentation as part of the standard exit procedure. However, some smaller clinics may rely more on verbal instructions, and they are less likely to build and maintain a dossier on your case.