Cervical Disc Replacement: A Life Changer for Detective

For Detective Michael Pavero, weakness, numbness, and pain in his neck and shoulders can be show stoppers. Assigned to the ATF Arson Task Force for Washington, D.C., he is a 20-year veteran of the D.C. Metropolitan Police Department, and his physical readiness is required for his own safety, his colleagues’, and the citizens he protects.

So when Detective Pavero woke one morning with upper left arm pain, he assumed it was a temporary pulled muscle, wrapped it in an Ace™ bandage and went about his day. But two days later, his fingers were tingling. Detective Pavero, 47, was a little concerned it might be something serious. Doctors at a local Emergency Department diagnosed a pinched nerve and prescribed pain medication.

The pinched nerve did not go away. For the next several months Detective Pavero ping-ponged between his primary care physician, an orthopaedist, and a neurosurgeon, along with treatments of physical therapy, steroid shots, and pain medication. Not being 100 percent, he was either on sick leave or desk duty at work.

An MRI found a herniated cervical disc and bone spurs, and a spine surgeon told him he had two choices: live with it, or have a procedure called anterior cervical discectomy and fusion, or ACDF. The procedure relieves pain and numbness by removing the problem disc and replacing it with a piece of bone, a metal plate and screws. Over time the vertebrae fuses and stabilizes that part of the cervical spine. While the surgery relieves pain, the patient loses some range of motion. And there is a long recovery.

Had Detective Pavero been retired, or in another profession, he says he may have opted for fusion. “But a physician on the police force told me that it was highly likely I would be forced to take early retirement,” he says, “because I’d have limited mobility and wouldn’t be able to perform at 100 percent. I knew I couldn’t survive on 15 to 20 percent of my salary.”

One of the doctors he had seen mentioned cervical disc replacement (arthroplasty), but said he wasn’t a candidate. Yet the mere possibility of another option sent Detective Pavero to the internet looking for a second opinion.

“I came across Dr. Oliver Tannous,” he says. “He had fabulous reviews from patients and did disc replacement surgery.” Detective Pavero made an appointment with Dr. Tannous at MedStar Orthopedic Institute at MedStar Washington Hospital Center. “Dr. Tannous told me disc replacement surgery WAS an option, and I’d be a good candidate for it,” he says.

“In cervical disc arthroplasty,” explains Dr. Tannous, “instead of fusing vertebrae together, we replace the disc with animplant that mimics normal disc motion. It basically functions as a joint that allows normal range of motion and reduces stress on the discs above and below. The most amazing part about this technique, other than sparing your range of motion, is the short recovery period.”

While it sounded like a great solution to the detective, “I didn’t immediately jump on board,” he says. “I wanted to try a little longer with physical therapy and other things I was doing.”

Dr. Tannous agreed. He prefers to try more conservative methods first. “In fact,” he says, “if you’re experiencing neck and arm pain due to disc herniation or cervical spinal stenosis, you may not need surgery at all. About 75 percent of our patients get better using physical therapy, anti-inflammatory medications, or steroid injections. It’s only after we’ve exhausted those options that we talk about surgery.”

For Detective Pavero, “some days would be ok, then I’d turn my head the wrong way, and pain would shoot up my arm. I wasn’t happy. I was either on desk work or at home just moping around. I couldn’t mow the lawn or do much of anything physical.”

A month after first meeting with Dr. Tannous, Detective Pavero made up his mind and had the surgery. Dr. Tannous had warned Detective Pavero that fusion could still be a possibility. “He told me he was planning to do the replacement, ‘but if I get in there and your anatomy is not what it looks like on film, I’ll have to do a fusion.’”

Detective Pavero was in luck. “When I woke up,” the detective recalls, “the first thing I did was feel for a collar, which would have meant I’d had fusion. For a minute I wondered if I’d even had surgery. But I had no pain, so I knew he was able to do the replacement.”

And the recovery was equally successful. Not only was he immediately without pain and could move his neck freely, he says, “I had a day of coughing, a day of eating soup, a day of eating soft stuff, and by day four I had a pork chop!”

Six weeks after surgery, Detective Pavero was cleared to return to work. Since returning, he’s had to take tests on the firing range and in defensive tactics training. He passed with no problem. “If I’d had fusion,” he says, “it would have been six months rather than six weeks before I could return to work—if I could return to work at all.”

Ever grateful to Dr. Tannous, he says, “There are a few people, or events, that change your life. Meeting Dr. Tannous was one of those for me. It was as though I was on a road, my car broke down, and I had to get off. Then Dr. Tannous came along and put me back on the road so I could drive again.”

“In cervical disc arthroplasty, instead of fusing vertebrae together, we replace the disc with an implant that mimics normal disc motion. It basically functions as a joint that allows normal range of motion and reduces stress on the discs above and below. The most amazing part about this technique, other than sparing your range of motion, is the short recovery period.”

—­OLIVER O. Tannous, MD

Replacement