Texas Rangers’ Prince Fielder Grounded

Texas Ranger’s first baseman Prince Fielder is set to undergo neck surgery which will sideline him for the rest of the season.

According to spine specialist, Dr. Drew Dossett, the 30-year-old will undergo neck fusion surgery to repair a herniated disc.

Rangers GM Jon Daniels told ESPN that Fielder had complained of pain and weakness in his left arm. He received a nerve-root injection last Saturday, which seemed to help- at least temporarily. On Tuesday, he again complained of left arm weakness and he was seen by Dr. Dorsett for further evaluation. According to Daniels:

“I wasn’t surprised, just because after talking to him and seeing him, you know this was something that was bothering him. We were hoping the injection could get him through the season. His initial response was positive. But the symptoms came back.”

Fielder joined the Rangers in November in a blockbuster deal which traded All-Star second baseman Ian Kinsler to the Detroit Tigers. He had been batting .247 with 3 home runs and 16 RBIs before this injury.

Recovery from the surgery is expected to take 3 to 4 months, effectively ending this season for Fielder.

What is a herniated disc?

Herniated-Disc2The spine is made up of 24 bones called vertebrae, stacked on top of each other as well as the sacrum and coccyx (which are fused vertebrae at the base of the spine). Between the vertebrae are cushions made of cartilage, called the intervertebral discs, which keep the spine flexible and act as shock absorbers. Strong fibrous tissue, called ligaments and bony protrusions of the vertebrae called facets help stabilize the spine. There is an oval shaped space, called the spinal canal, through which the nerves pass from the brain down the spine. The spinal nerves then pass through a second space, between the vertebrae on each side of the spine, out to the rest of the body.

The intervertebral discs consist of a thick outer layer of cartilage, the annulus, which surrounds a jelly-like center called the nucleus. A disc is called herniated when the nucleus seeps out and pushes on the nerves coming out of the space between the vertebrae. Although a herniated or ruptured disc can occur by a single severe trauma, more commonly it occurs as discs get worn over time, causing them to become less springy, and flatter, and to develop small cracks.

The symptoms of a herniated disc in the neck includes pain with movement of the neck or pain that moves down the arm to the forearm and fingers. Numbness and weakness of the affected arm may also be present.

What is cervical fusion surgery?

Cervical spinal fusion is a surgery that  permanently joins selected bones in the neck. During surgery, the disc(s) between one or more vertebrae are removed, and bone growth between the adjacent vertebrae is stimulated to link them together. Often, a metal device is used to stabilize the fusion until the bone growth is solid.

The procedure:

  • An incision is made in the front of the neck and the muscles are pulled back with retractors to reveal the spine.
  • The herniated disc is removed.
  • Material is placed in the space between the two vertebrae. This can be:
    •  a section of bone- i.e. a bone graft (taken from elsewhere in the body or from a bone bank),
    • a special cage which is packed with bone graft material,
    • a synethetic bone substitute
  • Rods, screws or plates are placed across the vertebrae to stabilize the area while the bones are healing.

Here is an animation of the procedure:

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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