POLITICS ’88 : Problem Not Uncommon : Mrs. Dukakis’ Ailment More Severe Than Usual

Herniated cervical discs, the condition for which Kitty Dukakis was to undergo surgery this morning, is a not uncommon ailment in the middle-aged and elderly. But the vast majority of individuals who suffer from it can be treated with conservative measures such as rest, traction and pain medicines and never require an operation.

What makes the case of the 51-year-old Mrs. Dukakis different is the rapid onset and progression of her symptoms and medical evidence that the protruding pieces of cartilage between the vertebrae of her neck were pressing directly against her spinal cord.

“She was having problems with dexterity and progressive numbness in her hands,” said Dr. Edward H. Davis, the Cedars-Sinai Medical Center neurologist whom Mrs. Dukakis consulted when she first sought medical attention during a campaign stop in Los Angeles Saturday. “To leave her untreated would not be wise.”

Diagnosis Confirmed

Davis’ diagnosis of spinal cord compression was confirmed by a sensitive magnetic resonance imaging scan performed at Cedars-Sinai Saturday night.

Instead of functioning as shock absorbers between the bones of the spine, the discs between cervical vertebrae 4 and 5 and 5 and 6--there are 7 cervical vertebrae--were impinging on the spinal cord, the key nervous system conduit between the head and the rest of the body.

According to Davis, this spinal cord compression meant that the wife of Democratic front-runner Michael S. Dukakis was vulnerable to progressive weakness of her arms and legs, and potentially to quadriplegia. By comparison, in potentially less serious but still painful cases, the protruding discs may press on nerves after they leave the spinal cord.

To correct the problem, Mrs. Dukakis was to undergo an operation known as a cervical laminectomy and fusion, which was expected to take several hours early today.

Massachusetts General Hospital surgeons Dr. Nicholas T. Zervas, a long-time friend of the Dukakis family and chief of neurosurgery, and Dr. Lawrence Borges, chief of the hospital’s spinal cord service, were to make an incision in Mrs. Dukakis’ neck to expose the spinal bones.

Remove Damaged Discs

They were then to carefully remove the damaged spinal discs, probably using an angled cutting spoon and high speed drills, according to Dr. Frances K. Conley, an associate professor of neurosurgery at the Stanford University Medical School.

Finally, Dr. Frederick Mansfield, a Massachusetts General Hospital orthopedic surgeon, was to use a saw to cut off a small piece of Mrs. Dukakis’ hip bone. Two pieces of this bone were to be wedged into the spaces left behind when the discs were removed. This so-called bone “fusion” helps to maintain the spine’s structural strength.

Neurosurgeons and some orthopedic surgeons perform similar operations routinely and the prognosis for a full recovery is good.

Staff writer David Lauter in Boston contributed to this story.