For over a year, Andrea Hogue had almost unrelenting pain. It started in October 2019 with numbness that shot down her left leg, wrapped around her calf and caused her foot to spasm.
“I tried everything,” said Hogue, a sixth-grade teacher at a middle school in Merced, California. “Heating pads, ice packs, CBD oil, over-the-counter pain medications. But nothing worked.” Her doctors prescribed physical therapy and painkillers. The pain just got worse. For months, she couldn’t sit or stand. She spent most of her day in bed.
“It hurt to sit down,” said the 55-year-old. “It hurt to stand up. It felt like my whole left leg was in a permanent cramp.”
An MRI showed she had a herniated disc that was impinging on her spinal nerve. Spinal discs, which act as cushions between each of the 33 vertebrae that make up the spine, can develop bulges, or hernias, when the soft inner core protrudes through the tougher outer ring. If the hernia presses on a nerve, it can cause pain and numbness.
Hogue called Stanford Health Care – ValleyCare and was scheduled for a common spinal surgery called a discectomy. During this endoscopic procedure, surgeons remove the bulge that’s pinching a nerve. At first, the discectomy, which took place in July 2020, relieved much of her suffering. But Hogue was one of the 5% to 20% of patients whose disc reherniates after a discectomy, a worrisome outcome that researchers began studying at Stanford more than a decade ago. Two months after her surgery, Hogue was back where she started: in severe pain, lying in bed and in need of another option.
A few months later, a solution emerged: Her surgeon, John Kleimeyer, MD, clinical assistant professor of orthopaedic surgery, recommended she undergo a second discectomy, one that would include the implantation of a recently approved device designed to prevent reherniations. The tiny apparatus, called a Barricaid annular closure device, or simply Barricaid, consists of woven mesh attached to a titanium anchor. The anchor is implanted into the vertebral bone, and the mesh blocks the hole. Researchers who followed patients for six months after receiving the implant found that reherniations were greatly reduced.