Christy Talbott sleeps through the night now that the throbbing pain she used to feel when she
rolled on her left side no longer jars her awake. The pain that felt like a piece of steel had pierced her
skull when she wound up on her back is gone, too.
Undisturbed sleep was an immediate effect of Talbott’s March 2009 spinal surgery, a
procedure performed by neurosurgeon David Kee, M.D., of Carolina Neurosurgical
Services, at FirstHealth Moore Regional Hospital. “I’m sleeping through the night,”
she says. “I no longer need to take any medication to help me sleep.”
Talbott’s problem, later diagnosed as a ruptured disc, began in 2001 with
tingling and numbness in her left arm. She tried pain injections, but the
condition worsened. Two years later, she had nearly eight hours of
surgery during which the damaged disc was replaced with cadaver
bone fused with a titanium plate.
That helped, but the problem persisted, ultimately becoming so
bad that Talbott’s left arm began to atrophy from lack of use.
For several years, memories of her first surgery and a subsequent
night in intensive care kept Talbott from even considering a
second surgery. Then she heard about the new team of neurosurgeons
at Moore Regional and made an appointment with Dr. Kee.
Talbott worked the morning of her surgery, but took a day off
afterward. She describes the recent procedure as “a fraction of what
the original surgery was.”
“I’m glad I finally did it,” she says.
Neurosurgeon David Kee Jr., M.D., attributes Christy Talbott’s painful
problem to a ruptured disc and says that she had a similar condition, the
first involving a different disc, several years earlier. Another neurosurgeon
corrected the original problem in 2003, but with a surgical procedure
that lasted nearly eight hours and included an overnight stay in
|David Kee Jr., M.D.
With improved technology, Dr. Kee was able to do Talbott’s
March 2009 surgery as an outpatient procedure that lasted only
“I offered her essentially the same surgery,” he says, “but she
went home the same day and did very well.”
Dr. Kee went through Talbott’s old incision to remove a
titanium plate that had been placed during the first surgery. He
replaced it with a hard-plastic PEEK (polyethyl ether ketone)
cage that he attached to the neighboring vertebrae with a putty
mixture that encourages bone growth.
“The cage is radiolucent (see-through),” Dr. Kee says, “so we can actually see
bone growth occurring.”
According to neurosurgeon Bruce Jaufmann, M.D., neurostimulation
patients often say they haven’t felt so well in years. “A
lot of times, they have been on pretty heavy narcotics,
but have not had a lot of success managing their
pain with them,” he says. “They’ve run through the
gamut of treatment over a long time.”
|Bruce Jaufmann, M.D.
Long-term neurostimulation therapy involves the
permanent, although reversible, implant of a spinal
cord stimulator. First, however, patients must undergo
psychological screening and several phases of
testing and evaluation to determine if they would be
good candidates. After that, a physician specializing
in pain medicine conducts a clinical test to determine
the appropriate electrical impulse level and if the
patient is comfortable with operating the device.
aul Kuzma, M.D., is one of several anesthesiologists
at Pinehurst Anesthesia Associates who conduct
the stimulator trials. He says the best candidates
are usually patients with back or back
and leg pain who have tried “conservative”
pain therapies such as medication,
bracing, physical therapy, epidurals or surgery for a long time but
without success. “Those patients who don’t respond to the simple
therapies we may consider for a spinal cord stimulator,”
A trial can last for three days to a week, long
enough for the patient to live with the device in his
daily environment while going about regular daily
activities. If the trial is successful, Dr. Jaufmann surgically
places a permanent stimulator under the skin
of the abdomen, inserting coated wire leads under
the skin and into the spinal canal. The procedure is
typically done as an outpatient procedure involving a
local anesthetic and usually while the patient is awake
Neurostimulation therapy has been available for more than
30 years, but the technology has improved significantly during
that time, especially in the size of the generator and the batteries.
The generators are now very small, unlike early devices that were
roughly the size of two hockey pucks. Batteries are about the size
of a silver dollar. Current technology also includes more electrodes
and more options for programming.