The Amazing Journey from Quadriplegic to Active Senior: Due to the Quick Action and Skill of a TBI Spine Surgeon
Because of the accelerated pace of medical science, it is tempting to view what would have been seen as a miracle a few years ago, as commonplace now. Mrs. Deanna Ruckle of North Texas will not make that mistake.
According to Dr. Rajesh Arakal, a spine surgeon at Texas Back Institute, “Mrs. Ruckle is a 76-year old woman whom I met about a year ago, and at the time she was not doing well. She was in a rehab center and her health had been slowly deteriorating. She had recently gone from being in a walker to a wheelchair and lost the use of her hands and fingers. Her struggles were such that she could not even feed herself.
“Her neurologic function was deteriorating so quickly it became life-threatening.
“After examining her, I determined she had what a fair number of older patients have – degenerative changes of the space for the spinal cord in the neck. This narrowing was causing a compression of the spinal cord.
“In situations such as this, there can be changes in the spinal cord itself because there is not enough room for it. A minor trauma, such as falling or hitting one’s head, can start this process. This causes inflammation and develops into ‘central cord syndrome.’ Central Cord Syndrome is when the middle section of the spinal cord is more affected than the outer section and typically results in the patient’s loss of control of fingers and hands.”
Imaging Revealed the Problem
Advances in imaging technology allowed Dr. Arakal to identify the problem.
“Mrs. Ruckle had an MRI and CT scan,” he said. “These images allowed us to look at the bone structure within the spinal canal and the soft tissue of the spinal cord itself. We found the spinal cord had been transformed into the shape of an hourglass. There was compression in multiple sites, and, in some cases, the cord was about half of the cutoff point for the condition of spinal stenosis.
“There were areas of her spinal cord where it was compressed to less than five millimeters wide. Normally, the spinal cord in a healthy patient has a width of about 12 millimeters.”
The Surgery Was Challenging
Surgery is always the final option for patients of Texas Back Institute, but this severity of this condition suggested no other options.
“We performed surgery where we relieved the pressure on the spinal cord,” Dr. Arakal said. “This was challenging because, in someone who is older, it is very difficult to do a multi-level operation from the front of the neck where it is normally done which can result in other problems, such as the patient being unable to swallow.
“We did the surgery from the back of her neck whereby we exposed the muscles and removed the arches of the spinal column, and we secured the cord so that it would stay in alignment as the surgery healed. This process allowed her spinal cord to have more room, with no compression.
“This procedure is never ‘guaranteed,’ especially where the neurologic function of the patient had deteriorated so badly. In many cases, when a patient waits too long to correct this pressure, they don’t recover.
“Since this procedure, we have been given a grant from The Cervical Spine Research Society to study this problem. Our research has shown that, contrary to earlier thinking, it is better to treat these patients earlier than the literature advised. Historically, it was thought that operating on a patient who has lost walking function would not result in meaningful recovery.
“Mrs. Ruckle’s case disproved this. She went from someone who was not only wheelchair bound but also someone who had no hand function. Fast forward one year and now we are seeing her with good functionality in both her legs and hands.”
Meet Deanna Ruckle – A Woman with “All the Faith in the World”
One of the heroes of this medical miracle is, of course, the patient – Mrs. Deanna Ruckle. She showed unusual courage and unqualified confidence in the skills of Dr. Arakal.
“I was totally incapacitated by this condition to the point where I was taken by ambulance to the hospital,” she said. “In the course of trying to determine my illness, the hospital doctors ordered an MRI of my back, but not my neck. The neck region turned out to be where the problem lay.
“While I was undergoing physical therapy, it was determined that, in spite of my exercise, I was getting worse. This led to another MRI, and this time it included my neck. These images were given to Dr. Arakal and he immediately knew what to do.
“The first time I met Dr. Arakal, I knew I was in good hands. I looked into his eyes and saw care and compassion. After one conversation I was confident that I would do whatever he said needed to be done. Well, he said I needed emergency surgery, and within a week we did the procedure.
“I was, of course, nervous about having major surgery, but I am a very religious person, and this helped me. I knew that my path through the hospitals and therapy and then meeting Dr. Arakal was a part of God’s journey. I knew this surgery was life-threatening, but I went in with all the faith in the world.
“Now, I’m walking. I’m walking! I have my life back.”
A Full Recovery
Recovery from this type of major surgery requires determination on the part of the patient and the physical therapists at Texas Back Institute.
“Amazingly, she is now fully recovered,” Dr. Arakal said. “When I saw her in the office recently she had no cane, no rolling walker! Also, her hand function has fully recovered.
“She and her husband are making plans for travel and enjoying the time they have together. She takes limited medications for treating some arthritic aches and pains she has, but overall, she’s doing remarkably well.”
A Cautionary Tale
Mrs. Ruckle’s case is certainly a cautionary tale for older patients.
“Unfortunately, this type of condition is not that unusual,” Dr. Arakal said. “While not everyone who gets older will experience this level of spinal cord compression, as the population becomes older, there is certainly a higher prevalence of this.
“We have described a dramatic example with Mrs. Ruckle, but there are many patients who have this condition in various degrees. Some patients become symptomatic at lower levels of compression and some require higher levels before they notice the changes in their functionality.
“My advice to anyone who is getting older is to pay attention to these symptoms. For example, if you notice it is more difficult to open jars than it used to be, or you are worried about holding a glass of water for fear of dropping it, this may be something more serious than just getting older. Plus, having changes in one’s balance or numbness and weakness also suggest that spinal compression could be occurring. This should be checked out by an orthopedic specialist.
“Mrs. Ruckle’s case shows just how powerful proper and timely diagnosis is to correct this condition. It can have a life-changing effect.”
If you are concerned about weakness in your legs, arms or fingers, contact the spine specialists at Texas Back Institute for a comprehensive examination and diagnosis.
If you would like to hear the complete interview with Dr. Arakal and Mrs. Deanna Ruckle, click on SpineTalk below.