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  • Andrew Brengle

A little history

Updated: Jun 3, 2020

How did this all come to pass? I had known about my cervical/spinal stenosis since college, during the early 1980s. A blow from behind during lacrosse practice and momentary full-body paralysis (20-30 seconds) brought the condition to light. I was very fortunate not to be a quadriplegic. And after falling while skiing in Vermont on January 20, 2019, I again escaped a much more serious injury. Catapulted from both skis and landing on my head (glancing blow), I broke my neck: technically fracturing my C-6 vertebra. (Accompanying graphic here shows CT scan image of break.) Because it was a “stable” fracture, involving no moving or floating pieces - e.g. bones out of place, I was not immobilized. Again, supreme luck intervened. I could walk and move, and my spinal cord was not severed or compromised. It certainly was painful as I had pinched the nerve governing my left arm. Until the March 29 surgery, I slept little and rarely found a comfortable position outside of sitting or standing. I could not lie down flat or recline. You can read a short synopsis below that I typed up for my physical therapist following the surgery.

Doctors reviewing my x-rays, CT scan, and MRI, all told me my problem really wasn’t so much the fracture as it was my history of long-standing deterioration in the cervical region of my spinal column. Risk of paralysis either through sudden trauma or increasing myelopathy grew by the year. Indeed, over recent years I had noted tingling in my hands and a slight decrease in dexterity when manipulating small objects such as buttons and hand tools. Sitting at desks for long periods staring at computer screens was also becoming more difficult. About 2010 or so, a visit to a chiropractor alerted me to the fact that my spine in the neck area was in bad shape. I recall the chiropractor - after asking me to bring him an x-ray - telling me my neck was in the late stages of degenerative disc disease. He told me to get treatment beyond what he could offer. I was warned.

So with the ski accident and diagnostics, a window into my condition opened. Dumb luck gave me more chances than I probably deserved, considering other paralysis victims never get the benefit of second and third chances.

Here is the synopsis I gave my physical therapist.

Chronology

April 1980

Following a blow to my back and momentary full-body paralysis (20-30 seconds?) while playing lacrosse, I was diagnosed with a congenital fusion of the C2 and C3 vertebrae and a narrow spinal canal. Spinal contusion was suspected, and a myelogram was performed to rule out disc protrusion.

My neurosurgeon decided against surgery but advised me that I was more vulnerable to paralysis than most if I incurred further trauma to my spine.

1980 – 2019

I have led an active life, running, skiing, cycling, hiking, etc. On at least two occasions in early 2000s, while skiing and snowboarding, I recall blows to back and/or neck during falls, which resulted in neck pain and tingling in the arms. Pain receded in a day or two.

January 20, 2019

I fractured the left side of my C6 vetebra after falling on my head while skiing. The fracture was stable, but a CT scan and MRI revealed considerable spinal degeneration and stenosis. Pre-accident I was experiencing mild myelopathy in the hands and feet/numbing and tingling. Post-accident I had severe nerve pain in my left arm, presenting especially intensely in my left thumb, arm pit and underside.

January – February 2019

First consulted with Dr. Richard Azuna, orthopedic surgeon with Sports Medicine North. Also consulted neurosurgeon Dr. Timothy Smith at Brigham and Women’s for second opinion. Dr. John H. Shin, neurosurgeon with Mass General Hospital (MGH) then consulted and chosen for multi-level cervical fusion.

March 29, 2019

Posterior cervical decompression and fusion of C3 to T1 performed by Dr. Shin at MGH.

March – May, 2019

During initial recovery stage I had very limited upper body activity to allow bone graft to set. Walking was my sole form of exercise/activity.

Neurontin (gabapentin) 600mg daily, Tylenol 500mg, and wearing EMF bone growth stimulator 4 hours each day (Orthofix CervicalStim). Stopped opioid pain meds late April early May. Also took 5,000 units of vitamin D supplement daily to boost low iron levels in my blood and to support bone graft growth. Vitamin B Complex supplement also taken to promote spinal cord healing, although the connection has not been clinically proven.

As of early June 2019, weak upper body strength, very limited range of motion in neck, some general pain/discomfort in neck area, with residual sensitivity in left thumb pad.

#newyear #resolutions #old

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