Two Life-Saving Surgeries, 13 Years Apart

THE FIRST TIME MICHAEL ADAMSON met Board Certified Neurosurgeon Farhad Limonadi, MD, it was in the emergency room in 2005. Adamson, then 28, and his wife had been involved in a car accident. They were hit by a drunk driver and he suffered a herniated disc in his cervical spine (neck).

“Mr. Adamson had major compression of his spinal cord at the C5 to C6 level, resulting in significant pain radiating down his arm along with weakness,” recalls Dr. Limonadi. “It indicated the need for an urgent operation that consisted of exposing the cord and removing the herniated disc through a small incision in the neck, and placing a plate and screws to fuse and stabilize that part of his spine.”

“I remember Dr. Limonadi telling me I needed to go into the operating room right away or else I’d risk being a quadriplegic,” Adamson says.

The operation was successful, and Adamson returned to normal, pain-free function, immensely grateful for Dr. Limonadi’s surgical skill. “I believe he saved my life,” Adamson says of Dr. Limonadi.

Fast forward from 2005 to July 2018. “One Friday morning, my wife and I were sitting outside in our backyard and I reached for my coffee with my right arm,” Adamson relates. “My arm retracted like a broken rubber band and I had instant pain.”

He went to work anyway — at the time, he worked as a district manager for a beer distribution company — but the pain and pressure on his right side were so severe that it was hard to move. He saw his primary care doctor later that day, who diagnosed it as muscle tightness, prescribed some medication, and suggested a follow-up visit in two weeks.

“By that night, I couldn’t move; the pain was unbearable from my right shoulder to the elbow,” Adamson says. “I went to the emergency department where they took an X-ray, medicated me, and sent me home with more medication.”

By Sunday, the pain sent him back to the emergency department, and he was admitted to the hospital for three days. During that time, he underwent imaging to try and determine the root cause of his pain, without any definitive answers.

“The MRI of his cervical spine showed age-appropriate degenerative changes for a man of 41, and some narrowing of the foramen where the nerve root exits the spinal canal above and below his previously injured site,” Dr. Limonadi says. “It’s not uncommon to have degenerative changes adjacent to previous injury from his car accident, and the MRI confirmed such changes above and below his previous injured segment.

“But the narrowing of the foramen suggested there could be compression of his nerve roots that was causing the pain,” he continues. “So it was difficult to discern if his pain was stemming from musculoskeletal injury or if it was a true nerve injury. “If the nerve root was injured, it meant he’d have to have an operation on his cervical spine at the levels above and below his previous surgical site,” Dr. Limonadi adds. “But for a young man of 41, that would be nice to avoid.”

Reluctant to operate if it weren’t determined to be absolutely necessary, Dr. Limonadi continued to recommend conservative measures for a few more weeks, including cortisone injections and even a second hospitalization for intensive pain management, during which Adamson underwent a nerve conduction study.

“I give a lot of credit to Board Certified Neurologist Reza Nazemi, MD, who performed the electrodiagnostic studies and diagnosed Mr. Adamson with cervical radiculopathy and reassured me that a nerve root injury was, indeed, the cause of his pain, and that I should proceed with surgery,” Dr. Limonadi says.

Confident that he was taking the right approach for his patient, Dr. Limonadi performed surgery on Adamson on August 16, 2018.

“We used a newer technology that obviated the need for placing plates and screws,” Dr. Limonadi says. “We further removed his old plate and screws and achieved the same goal of decompression of his spinal cord with less metal and instrumentation. Mr. Adamson did great postoperatively, with immediate resolution of his symptoms.

“Mr. Adamson is one of those rare human beings who is real, super kind, intelligent, hardworking, and has a strong presence,” he adds. “He’s very engaged with his family and activities with his children. It was important to me, as our timelines were intertwined, to help him have a continued good journey.”

Adamson credits Dr. Limonadi with saving his life twice.

“Besides my grandfather and father in heaven, Dr. Limonadi is my angel here on earth,” he says, getting emotional. “He brought me back to my strengths, and I can’t say enough about his skill as a surgeon and his compassion as a person. I will never let anyone else touch me.”

To contact Eisenhower Neuroscience Institute, call 760.837.8020.