Neurosurgeon operates on woman and her daughter-in-law on same day

It’s common for women to spend time with their daughter-in-law doing things like shopping, eating out and going to the movies, but having surgery with your daughter-in-law on the same day with the same neurosurgeon is not something most people will ever experience.

That’s exactly what Joan Miller and her daughter-in-law Ellen Miller did. Both of them had been suffering from severe pain – Joan Miller’s was primarily from her buttocks down the back of her legs and Ellen Miller’s was mostly in her neck.

When Ellen Miller learned of an Advocate Condell Medical Center neurosurgeon who successfully treated her husband’s acquaintance, she scheduled an appointment and suggested Joan Miller do the same. The only catch, Joan Miller and Ellen Miller live in Dubuque, Iowa, and Dr. Jonathan Citow works almost 200 miles away in Libertyville, Ill.

The distance didn’t deter the women.

“After talking with him I said, ‘If anybody can fix my neck, it’s this man,’ ” Ellen Miller says.

Suffering for years

Ellen Miller, 56, had been experiencing neck and arm pain for a couple of years, and it was growing progressively worse.

She had been diagnosed with cervical spondylosis, which is caused by chronic wear on the spine causing the discs between her neck vertebrae and the joints between the bones of her cervical spine to degenerate. She had also developed bone spurs along the edges of her bones in that area. Over time, it had become increasingly difficult for her to move her neck as the pressure affected her nerves.

Joan Miller, 83, learned in 2012 that she had lumbar spinal stenosis. As the open spaces within her lumbar spine began to narrow, they put pressure on her nerve roots which traveled through her spine and into her legs causing pain, numbness and muscle weakness in her legs.

She sought medical treatment, but continued to suffer.

“Sometimes it hurt so bad I wanted to cut that part of my body out,” Joan Miller says, adding that she had just about given up hope when her daughter-in-law told her about Dr. Citow.

Dr. Citow says it’s not uncommon for him to see patients with similar stories of going from doctor to doctor seeking back or neck pain relief without finding one. By the time they reach him, many are desperate.

“Ninety percent of the people who come to me have seen their primary care physician and specialists who are unaware of the more modern, less invasive ways to treat both cervical and lumbar stenosis and other degenerative conditions,” Dr. Citow says, adding that when a more invasive approach is offered it can scare patients, discouraging them from pursuing treatment.

Step by step

Dr. Citow’s staff coordinated Joan Miller and Ellen Miller’s surgeries so that they were  back-to-back on the same day.

The day of the surgeries, they left Dubuque at 5:30 a.m. with Ellen Miller’s husband, Joan Miller’s son, driving.

For Ellen Miller, Dr. Citow performed a minimally invasive outpatient anterior cervical discectomy and fusion. This meant that he removed the discs and bone spurs that were causing her pain, and then he stabilized her spine with a cadaver bone and a small titanium plate with screws.

This minimally invasive approach used a much smaller incision compared with traditional surgery. The incision was closed in a plastic surgery style without any superficial sutures. After surgery, it looked like a paper cut covered with glue.

Ellen Miller also didn’t have to wear a collar, which is common for those who do not have minimally invasive surgery. Patients often are able to drive the next day as well.

“When I woke up I felt really good,” Ellen Miller says, adding that months later she barely had any pain. “My neck just felt a little heavy. It wasn’t that gnawing, twisting pain from before. It’s pretty amazing.”

As for Joan Miller, Dr. Citow performed a minimally invasive outpatient hemilaminectomy with bilateral decompression. This procedure involves an incision about the length of a thumbnail.

Dr. Citow worked through a small tube with the use of a microscope and specially developed tools, many of which he invented himself. He removed the bone spurs and overgrown ligament that had been compressing her nerve roots. That relieved the narrowing of the spaces, eliminating the pressure and subsequent pain.

“After the surgery that pain was gone,” Joan Miller says. “I didn’t feel it at all. It’s almost a miracle.”