For 85-year-old Paul who has been a section violinist for decades, playing the violin is one of his greatest joys. Paul thought he was nearing the end of his performing career when severe lower back and legs pain made it impossible for him to sit through rehearsals.
He was offered “fusion surgery” which would stabilize his spine and decompress the spinal nerves, relieving him of pain. This approach would have also reduced his mobility to a point where playing the fiddle would have been impossible. It would have required a hospital stay with all the risks associated with major surgery including pain and blood loss.
Paul’s options changed dramatically when he learned about a new procedure that not only relieved pain but also preserved motion. Paul was able undergo a multilevel but less invasive outpatient procedure lasting only one-and-a half hours. This allowed him to sleep comfortably in his bed and, most importantly, play the piano again.
David Yeh, a neurosurgeon, was able to make this inspiring story possible. Dr. Yeh said, “The beauty of this motion procedure is that it uses an implant that’s flexible and stable enough to allow movement without the invasiveness or decreased range of motion of spinal fusion.”
An Inspirational Neurosurgeon
Dr. Yeh faces a daily challenge to help his patients continue to do what they love when their bodies no longer cooperate. He calls it fighting an aging machine which cannot be stopped. “The magic of life is optimizing movement,” said Dr. Yeh. “That is my ultimate objective, especially for string players.”
Dr. Yeh is also a violinist. He is a professional violinist.
I have seen him perform live, and written about his musical talents in the past. He knows that fiddlers are more prone to spinal degeneration due to the stress they put on their joints. His senior thesis “Neurophysiology for Violin Playing” was a preview to his future thinking, even before he began his formal medical training.
Dr. David Yeh is a neurosurgeon, violinist and neurosurgeon.
Dr. Yeh compares the results of his surgical motion procedures to those of traditional fusion surgery. “A piece played in one way is called a caprice, and another way it’s called an etude.” While spinal motion procedures seem revolutionary, they are essentially the same technology used to transform traditional hip and knee fusions of the past into standard joint replacement procedures which allow for continued mobility and range of movement.
Dr. Yeh is quick in pointing out that, when patients need spine surgery, the decision between “fusion” or “motion” can be a complex clinical decision requiring extensive discussion with each patient. He wants to be a voice for string players who are considering motion therapy as an option if they need surgery. “There is no doubt that fusion surgery works. It can reduce pain and increase nerve functionality, which is no small feat. It’s not the best fix because the areas above and beneath the fusion also break down over time. The motion procedures use spinal instrumentation to allow movement at the joint. This preserves or restores function as best as it can. “I hope that string players with their very specific needs will understand that there may be other alternatives that could help prolong the ability to play.”
Case Studies and Tele-Medicine
Paul’s story is just one of Dr. Yeh’s many success stories. Locally, a 52-year old violinist with severe neck and arm pain, multiple degenerative disks compressing spinal cord and nerves and multiple degenerative discs was offered fusion surgery. It would have also significantly reduced her ability to play violin. She flew across the country to see Dr. Yeh who she describes as “a gifted and humble surgeon and a human being.” After a two-hour procedure performed in an outpatient setting, her left arm had regained full strength. She also gained movement in her neck.
Then there was 71-year old woman with herniated discs in the neck. She was told that she had two options: either a major neck fusion or a painful back decompression. Dr. Yeh used a hybrid technique, which involved removing the deteriorated disc and stabilizing the area above an existing fusion using a flexible artificial disk.
You don’t need to fly to California for a consultation. “Covid has proved that telemedicine works. It’s convenient, affordable, and allows patients the opportunity to consult with doctors in other geographic areas.” Dr. Yeh consults with patients from around the world to discuss surgical options. Patients may then choose to have the procedure performed in their home state.
Music as We Age
I ponder aging endlessly. I understand the alternative. It’s not pleasant. But I am always amazed at how young bodies can move. I know that I would never be able to do this. I see girls in my neighbourhood practicing back flips. I wonder, “How can a body do that?” I watch my son, who is now an adult, lace up his hockey skates and escape body slams with speed, and think “No!” I’ve never watched a violinist, and thought “I remember when i could do that.” I can still do it.
I’m encouraged to know that, if I ever experience neck or back issues, there are compassionate doctors like Dr. Yeh who will give me the best options to maximize my mobility and keep my violin in my life.
Dr. Yeh’s compassion is a result of his own experience as an accomplished musician. He keeps music at the forefront in his life as a performer, an audience member, and a financial supporter. He was fortunate that his college professor, who taught violin, made sure to make him aware of the “many other ways” to live a rewarding life musically without being a concertist. He has been able understand the importance of music to those who seek his help, whether they are professionals or amateurs. It doesn’t matter to him if they play for fun or for a living. He knows that every musician wants to make great music.
Dr. Yeh said that there is nothing more satisfying to a surgeon than hearing a patient say he has given them back their life, they no longer suffer, they enjoy life and are active again, and can play their instrument. “It doesn’t get any better than that.”
He has made it a mantra to ensure that there is movement, music, and mobility in his patients’ life. “We are blessed that we can make music for the rest of our lives with the mobility and movement we have.” It’s worth doing whatever it takes to keep it.”
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