Patricia’s Story — Come Back from Back and Neck Pain

For almost a decade, Patricia Gorgone has faced a series of back and neck injuries. Each time, Ali Moshirfar, MD and Inova’s Spine Program were there for her.

Patricia Gorgone is a woman at the top of her game. A CEO for a proposal consulting firm, she spends her days meeting with clients, managing staff and charting company’s path to future success.

In 2014, she developed problems in her lower back. Like many busy people, Pat tried to cope with the pain – until it was impossible to tolerate any longer. When she arrived for her consultation with Ali Moshirfar, MD, Medical Director of Inova’s Spine Program at Inova Loudoun Hospital, she was confined to a wheelchair.

Dr. Moshirfar conducted a detailed diagnostic examination, reviewing imaging and talking with Pat about her symptoms. He determined that a disc between two of the bones in the lumbar region of her spine was bulging – and that Inova’s Spine Program had the expertise and resources to help.

“The Inova Spine Program’s team of spine specialists provides the excellent care patients need. Every physician in our program is vetted and must meet strict criteria. Our dedicated team includes nurse navigators who help streamline the process of getting tests, meeting with specialists, and orchestrating treatment and procedure scheduling,” Dr. Moshirfar said. “Patients get better care, and have a better experience.”

After Dr. Moshirfar performed a lumbar discectomy, Pat recovered from surgery and returned to her busy and active life. She didn’t expect to see Dr. Moshirfar again for many years, if ever. But fate had other plans.

“Dr. Moshirfar took the time to ask questions, conduct a thorough examination and review the X-rays. Then he talked me through everything and presented all of my options,” Pat said. “He and his team were always there for whatever I needed. They are absolutely fantastic.”

In 2018, Pat was rear-ended while her car was sitting at a traffic light. She experienced numbness and tingling in her left arm, as well as pain in her lower back. She followed up with Dr. Moshirfar. After talking with Pat, reviewing X-ray and MRI results, and conducting an examination of her neck, Dr. Moshirfar diagnosed her with degenerative disc disease between the fifth and sixth vertebrae in her neck. He prescribed physical therapy, and Pat also tried trigger injections and steroid injections to control the pain.

“At the Inova Spine Program, and in our practice, we are very conservative when it comes to treatment. We tried everything possible to avoid surgery,” Dr. Moshirfar said. “Who wants to have neck surgery if they can avoid it?”

However, none of the conservative treatments provided long-term relief. “I was losing the ability to use my arms,” Pat said. When she was unable to summon the strength necessary to push an elevator button, or to type on her computer at work, she knew it was time for surgery.

In November 2018, she returned to Inova Loudoun Hospital for her neck surgery, performed, as before, by Dr. Moshirfar. “The hospital was great. The surgical team explained everything and answered all of my questions,” Pat said. “They did everything they could to make me feel comfortable and calm. I was up and moving the next day.”

After the successful neck surgery, Pat’s lower back troubles returned, made worse by the 2018 car accident. “We did everything we could to avoid surgery, but it got to the point where I couldn’t sneeze, cough or even laugh without excruciating pain,” she said.

Dr. Moshirfar found that the same lumbar disc had re-herniated. Her options were to have another discectomy, called a revision, or to have a laminectomy to free up the nerve and a fusion to stabilize that portion of the spine. Spinal fusion surgery “fuses” two or more vertebrae into one with bone graft supported by metal screws and rods. Pat chose to have the fusion, and in May 2019, Dr. Moshirfar performed this surgery as well – Pat’s third.

“The fusion removes the disc, so that it never happens again. However, it is a bigger procedure,” Dr. Moshirfar said. “During the surgery, I was very pleased that she had chosen to go with the fusion. I could see that she would have required a fusion sooner or later.”

Throughout her multiyear spine journey, Pat was grateful to have a relationship with Dr. Moshirfar and the Inova Spine Program’s care team. “During the time I have known her, I have had three children, and she would always ask to see the latest pictures,” Dr. Moshirfar said. “Part of the joy of medicine is building a trusted relationship with the people we treat.”

Pat agrees. “At this point, I feel like a friend of the family. Surgery has been life-changing for me. I’m not stuck in bed,” she said. “For the first time since 2015, I am completely pain free.”

To learn more about Inova’s Spine Program, part of Inova Neuroscience and Spine Institute, visit inovaspine.org.