What we Can Learn from a Pro Athlete’s Journey to Neck Surgery (SpineUniverse)
MLB third baseman David Wright undergoes surgery for herniated cervical disc
In light of the recent news that New York Mets’ third baseman David Wright elected to undergo neck surgery to repair a herniated disc, there has been a buzzing discussion on the impact of such a decision on Wright himself, the team, and the season. And most of the questions swirling distill to one: Is this the right choice given the circumstances?
Professional athlete or not, this is a question most patients grapple with when it’s time to consider spine surgery—it’s a mentally taxing topic. There are a million questions that dance around in a patient’s head.

Have we really exhausted all other options?
Will I make a complete recovery?
Will what I’m giving up be worth it in the end?

As a spine surgeon, I can tell you that the patient’s health and quality of life to come are the major drivers of our treatment recommendations. And though some sacrifices may have to be made, sometimes surgery may very well be the answer that will supply the best outcome. It is equally important, however, for patients to be on the same page with the course of treatment recommended—both surgeon and patient must move forward hand-in-hand.
I can say with confidence, that for almost any patient (and I’ve treated many) surgery is not something that is even considered until other treatment options have been fully exhausted and have failed to provide adequate relief. In Wright’s case specifically, his treatment team made the decision to proceed with surgery after many tests, rest and anti-inflammatory medications and injections were administered and did not sufficiently alleviate his pain or improve his ability to move his neck properly. This kind of assertive nonsurgical treatment is delivered with the hope of providing a suitable resolution of symptoms that would deem surgical intervention unnecessary. Immobilization, medications to reduce inflammation, swelling and pain, slews of diagnostic tests (X-rays, MRI’s), and intense physical therapy are all front-runner treatment options delivered with the hope to avoid the next more serious step.
However, after trouble shooting herniated disc problems with all the different nonoperative treatments, and being presented with no promising results, surgery becomes the next best option when a patient can’t live everyday life without pain and immobility. For Wright, this was the next logical step to relieve his neck pain, while simultaneously giving him hope to perform at his highest playing level once again. In fact, in a recent interview he said: “After trying every way to get back on the field, I’ve come to realize that it’s best for me, my teammates and the organization to proceed with surgery at this time.”
It is not uncommon for patients with recurring neck pain to decide it is in their favor to proceed with surgery in the hope that they can return to a pain-free and fully functioning life, especially when they’re faced with the alternative of the daily discomfort and disability brought on by a neck or spine injury. These decisions are probably also due in part to the positive prognosis that follows minimally invasive spine and neck surgery. Because these advanced techniques avoid disrupting muscles and soft tissues, there is less pain and recovery time, as compared to traditional open surgery procedures. Patients can expect to be discharged home same day and while there will remain some period of discomfort and recovery; it can be easily relieved with pain control medication. Physical therapy will also be recommended to help rebuild strength of the muscles and in doing so, speed the recovery process.
So how long will it take to return to daily activities, or to get back on the playing field?
That is the often a patient’s most burning question. Wright is facing a herniated disc neck surgery, which typically requires a three-month recovery period. However, every patient has their own recovery timeline based on their individual condition, the procedure involved, the surgeon’s skill and the patient’s compliance with their after-care plan. In most cases, especially for patients who have a strong desire to get back to normal, pain-free living—the recovery period is often far less than the period of time that they suffered in near-constant neck pain.

ANOTHER FOOT DOC PLEADS GUILTY TO FRAUD (Orthopedics This Week)
What is it about foot doctors and healthcare fraud?
For the third time in the last couple of years, a podiatrist has pled guilty to defrauding Medicare and other payers.
First it was Virginia podiatrist Ilene Terrell, D.P.M., who was sentenced to five months in prison in 2014 for lying to a grand jury about falsifying patient medical records and prescribing an Orthofix, Inc. bone growth stimulator where the claim would not have met Medicare’s guidelines
Then it was California podiatrist, Neil Van Dyck, D.P.M. who was sentenced this past April to three years in prison and a $10,000 fine for committing healthcare fraud. Van Dyck submitted over $2.8 million in fraudulent claims for reimbursement to Medicare, Medi-Cal, Tricare and private insurers. He falsely claimed that he performed more expensive procedures than he actually performed.
Now its Pennsylvania podiatrist Stephen Monaco, D.P.M., who pled guilty on August 23, 2016 for $5 million in fraudulent billings to Medicare, Medicaid and four private insurance companies. Monaco admitted that he had committed the fraud using his practice, A Foot Above Podiatry, Inc., located in Havertown, Pennsylvania.
Between January 2008 and October 31, 2014, according to the government, Monaco submitted fraudulent claims for podiatric procedures that were not provided, and podiatric procedures that were not performed, including injections, debridement (removal of dead, infected or foreign material to promote wound healing) and nail avulsions (removal of the entire or partial nail plate).
Monaco faces up to 10 years in jail. Sentencing is scheduled for November.
We are not aware of any official speculation as to why some foot doctors have been prone to committing fraud. But it’s worth noting that all three of these podiatrists were owners of small independent medical practices where internal oversight of billing practices is different from large healthcare systems. To be fair, large systems have signed plenty of settlement agreements over the past few years with the U.S. Department of Justice over alleged fraudulent billing practices.