Around four years ago, Hannah Polach, 42, began experiencing numbness and tingling in her arms that would wake her from a deep sleep.
By 2024, her arms went numb every time she sat down. She felt a pinch in her neck every time she looked up. She started physical therapy near her home in Tulare County, but it barely relieved her symptoms.
"I was having to stand a lot of the time, and it affected my sleep" recounted Polach, who is an emergency room nurse. "My x-rays looked fine, but I knew something was wrong."
An MRI revealed Polach was suffering from degenerative disc disease, resulting in herniations and nerve root compression. She started more physical therapy, epidural corticosteroid injections, trigger point injections, and pain medications. But it wasn't enough.
The misery finally led her to seek surgery to relieve the nerve compression.
She was initially apprehensive of having surgery, and met with three other orthopaedic surgeons before selecting Safdar Khan, a professor in the UC Davis Health Department of Orthopaedic Surgery. He is also the Peter and Sophie Pappas Endowed Chair in Spine Surgery.
Khan recommended an innovative spinal implant called the Simplify Cervical Disc, which can restore mobility and relieve discomfort.
"Dr. Khan took time to explain the procedure, where others made me feel rushed and uncomfortable," Polach said. "I felt confident going with a reliable institution like UC Davis."
Options for degenerative disc herniations and nerve compression
Advanced age, physical trauma, or genetic factors can lead to degenerative disc disease, involving damage to the soft, flexible discs between each vertebra that allow for spinal mobility. About 400 million people worldwide are diagnosed with the disorder annually.
At UC Davis Health's new outpatient surgery center, 48X Complex, orthopaedic surgeons like Khan apply advanced surgical techniques to improve mobility for patients like Polach. In her case, Khan replaced Polach's degenerating discs with the new type of cervical discs, which can relieve pressure on irritated nerves.
Khan, who is also the vice chair for surgical innovation at UC Davis, compares vertebral discs to jelly donuts. The soft discs between each vertebra are filled with a squishy collagen gel. These fluid sacs act as shock-absorbing cushions that allow for spinal flexion.
Two of the discs in Polach's neck were compressing the nerve going down her arm. Their contents were bulging out and causing the pressure and her symptoms.
"When I met Hannah, she was in considerable distress," Khan said. "The pain was really impairing her ability to experience life's joys."
At one time, Polach's only option would have been spinal fusion, a procedure in which surgeons remove damaged discs and fuse affected vertebrae together to restrict the area's range of motion. However, everyday movement can damage adjacent vertebrae.
"Data suggests nearly 23% of patients develop further pathologies above and below the operation site within a decade of fusion surgery," Khan explained.
While fusions are right for some, Khan strives to help patients maintain mobility. In Polach's case, he recommended implanting two Simplify Cervical Discs.
"This FDA-approved device is on the leading-edge of options available for patients with neck and arm pain that is resistant to physical therapy, anti-inflammatory medications, or pain-relieving injections," Khan explained.
The synthetic discs consist of a ceramic core sandwiched between two plates of medical-grade plastic coated with titanium. Their dynamic cores allow for flexible movement of the spine. The device has been approved for replacement of up to two adjacent discs.
"This technology can allow patients to continue what they love to do and perhaps add more activities," Khan said. "A disc replacement may actually enhance a person's quality of life."
The procedure
To install the replacement discs, Khan made a small incision in front of Polach's neck and used a microscope and other precision instruments to remove the damaged discs. Under x-ray guidance, he sized the prostheses to relieve nerve pressure. He created small slots in her vertebrae and slid the new discs between them, ensuring their fit through imaging.
The procedure lasted around an hour and fifteen minutes. Polach stayed at the 48X Complex until she was stable enough to drive and returned home with a soft collar to protect her neck. Patients with severely limited mobility prior to surgery will likely require physical therapy within a few weeks of the procedure.
"I could definitely tell the first night that the numbness and tingling in my arms was gone," she said. "It was an immediate fix, and I'm no longer taking any nerve pain medications or cortisone injections."
Khan said it was a privilege to help a fellow health care worker recover her mobility.
"At UC Davis, we pride ourselves in providing superb care," Khan said. "Anyone with severe, unrelenting neck and arm pain should reach out for an evaluation. We're happy to see if they qualify for a disc replacement procedure."
