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Feeling Under Pressure

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Doctors: Deborah L. Benzil, MD, FACS, FAANS, Neurosurgeon, Director, Spine Radiosurgery Program; and Marshal Peris, MD, FAAOS, President, Medical Staff, Co-Director, Orthopedic and Spine Institute, Spine Surgery Section, both of Northern Westchester Hospital

Patient: Robert Colleluori, 48, Mount Kisco

Diagnosis: Compressive Blood Clot in the Spine


The Presentation

While sitting on his couch the evening of June 24, 2013, call-center manager Robert Colleluori suddenly felt a sharp pain in his neck. The pain quickly became so overwhelming, he was no longer comfortable sitting, standing, or lying down. He realized something was very wrong and told his husband, Allan, “You need to take me to the emergency room.”

 

The Journey

Robert was admitted to the ER of Northern Westchester Hospital in Mount Kisco, where a battery of tests were run. “Neck pain is a very common symptom presentation in the ER,” says neurosurgeon Deborah L. Benzil, MD, who treated Robert. Because there was no trauma, the ER staff initially surmised that, like many other visitors to the ER on that especially hot day, Robert had suffered a pulled muscle linked to dehydration.

They administered painkillers and muscle relaxers, and continued to observe him. Robert, however, could sense it was something more. “I didn’t feel right,” recalls Robert, whose hands and feet had begun to become numb and lose function. “Paralysis was setting in.” Close to midnight, the ER staff ran a CT scan on his neck, which revealed a small shadow on his cervical spine. Concerned, they immediately emailed the image to Dr. Benzil.   

She ordered a cervical MRI, which showed the presence of a blood clot pressing on Robert’s spinal cord. “In 35 years of practice, I have only seen maybe 10 of these cases,” Dr. Benzil says. Given Robert’s rapid loss of function, she asked for an operating room to be prepared, enlisted the help of her colleague, orthopedic spine surgeon Marshal Peris, MD, to assist with the surgery and headed immediately to the hospital.

According to Dr. Peris, there was a real concern that the damage might be irreversible. As such, “the goal of the surgery was to get the pressure off of the spinal cord as soon as possible.”

 

The Outcome

The surgery went smoothly, but Dr. Benzil had witnessed variable outcomes with this kind of condition over the years. She was therefore delighted when, in the recovery room, Robert said, “I think I can move my toe” — and did.

Three days after surgery, he was up and walking and then spent the following six weeks in rehab. That October, four months after surgery, Robert took a three-mile hike in the Berkshires with family. “Today, he has excellent function in all of his extremities,” reports Dr. Benzil. While Robert enjoyed a remarkable outcome, the enormity of what might have been is not lost on him. “It hits you,” he says. “It hits you hard. It does change how you view life — you don’t take things for granted any longer.”

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