Diane Mirante, Neurology/Spine

Back in the Game
A Spine Surgery Success Story

Diane Mirante considers herself a lucky person – a job she loves, wonderful health and aloving, supportive family.

"My everyday life is pretty ordinary," she laughs. "I don't consider myself special in any way, but I am also blessed in many ways."

Last year on Halloween, Mirante, 45, gave up smoking. A few days later, the Magnolia resident woke with a dull ache between her shoulder blades. She has worked in healthcare for more than 19 years – most recently as an admitting representative, and prior to that as a certified nurse assistant – so she initially took the achiness in stride.

As the days passed, the pain grew more severe. A normally active person, Mirante had to curtail her activities, abruptly halting spinning classes and walks with her dog, Rocco.

"I couldn't even drive," she said. "My mom drove me to medical appointments." Her primary care physician thought it was a cervical spine strain due to her sleep position. Despite some recommended exercises and medications, the pain became worse. She knew something was not right and, at that point, became her own health advocate. She sought the advice of Dr. Daniel Lazar, a Northwest Hospital neurosurgeon, who practices with Neurosurgical Consultants of Washington.

"My MRI showed a bulging disc that was pinching a nerve in my neck," she said. "I couldn't believe it. Dr. Lazar assured me he would get it taken care of. I knew I was in good hands because he treats a lot of patients with cervical spine injuries and I always hear good things about him from patients and nurses."

The spine is an intricate set of bones (vertebrae), muscles, nerves and discs (the rubbery cushions between the vertebrae). It contains five regions: cervical (neck), thoracic (chest), lumbar (low back), sacral (pelvis) and coccygeal (tail bone). Each vertebra is separated from its neighbor by a disc, which acts as a cushion or shock-absorber between the bones. About the size of a quarter and one quarter of an inch thick, these discs help the spine bend and move with ease.

Normally, discs remain contained between each bone, but they can herniate (also known as bulging, ruptured or slipped discs) when their fibrous covering is torn or breaks down from age or injury. Nearly 90 percent of herniated discs occur in the lower spine where there is more movement. Mirante was in the smaller group, with a herniated disc between cervical bones five and six in the middle of her neck.

"Herniated discs like Diane's can be caused by an injury, but most of the time, it's just wear and tear," said Dr. Lazar. "Herniated discs are usually very painful and can actually be damaging or debilitating if left unattended or untreated. In Diane's case, the disc was pressing against a nerve root in her neck."

Dr. Lazar performed minimally invasive surgery to address the problem.

"I made a one-inch 'keyhole' incision on the back of Diane's neck, located the fragment of the disc that was hitting the nerve and removed it," said Dr. Lazar. "It was a very small portion of the disc and will not affect her physical function in any way."

The smaller surgical incisions used in minimally invasive procedures have many patient benefits – less blood loss, lower infection risk and faster recovery time. The procedure lasted about an hour and Mirante was able to return home following an overnight stay. After a few weeks, she returned to part-time work and started four weeks of physical therapy at The Sports Medicine Clinic, a Northwest Hospital-affiliated clinic. She returned to a full-time work schedule just a couple of months after surgery.

Mirante says physical therapy and therapeutic massage played a big role in her return to the activities she enjoys.

"Alison Gillespie was my physical therapist and she provided terrific care during my recovery," she said. "She showed me how to stay active while recovering and I had no weight gain! That made me very happy."

"I restricted Diane's activities for the first month following surgery," Dr. Lazar said. "I expected no lifting or overhead work in order to rest her neck. She was then able to return to normal activities, but not too rigorous. We all have aches and pains, but anytime you experience numbness or pain that doesn't go away, especially if the numbness travels down your arm or leg, see your doctor."

Dr. Lazar said herniated discs and other spine injuries can be prevented by reducing stress on the spine, including maintaining a healthy weight, doing core-strengthening exercises and staying physically fit. Both smoking and unsafe heavy lifting can also lead to herniated discs.

"If you smoke, your primary care provider can recommend a number of ways to help you quit," said Dr. Lazar.

"I am so glad I had the surgery and was so lucky to get this taken care of quickly and thoroughly," Mirante said. "The pain caused quite a lifestyle change and I am so happy everything's back to normal!"

She recently travelled to Palm Springs, once again attends spinning classes three times a week, and takes long walks with her dog. This summer, she is planning tennis lessons.

"Dr. Lazar is excellent," she said. "He spends a lot of time with you and explains everything. He is straight to the point and has a wonderful team."

For more information about Neurological Consultants of Washington, call 206.368.1701 or visit nwhospital.org/neurodocs. For more information on The Sports Medicine Clinic, call 206.368.6100 or visit thesportsmedicineclinic.com.