DANBURY, Connecticut, November 15, 2018 — “I always knew who polished their shoes and who had a pedicure,” said Ellen Mullane, a New Milford, Connecticut resident. This bit of humor helped Mrs. Mullane describe what was in every other respect a very difficult situation. For nearly two years, Mrs. Mullane could not lift her chin off of her chest unless she held her head up with her hand or she wore a neck brace. She had developed a condition known as “dropped head syndrome.”
Mrs. Mullane developed this rare syndrome secondary to an underlying condition called cervical dystonia, which she had been managing for 25 years. She had sought care from several physicians, and tried numerous therapies to correct her dropped head syndrome, all without success. Her faith and perseverance ultimately led her to , MD, spine surgeon and Chief of Spine Surgery for Danbury Hospital.
In 1991, Mrs. Mullane was in a serious car accident. Months after the accident, she started to have debilitating neck spasms. At the time, Mrs. Mullane was diagnosed with cervical dystonia, a rare and painful neurological condition that caused the muscles in her neck to contract involuntarily. The neck spasms rippled through her arms and down her legs.
There is currently no known cure for cervical dystonia. The condition is often treated with oral medication, botulinum toxin injections, or surgery. Mrs. Mullane’s physician at the time recommended botulinum toxin injections for her, which she had every three months from 1993 to 2016. The injections relieved Mrs. Mullane of the disabling cervical dystonia symptoms. However, in April 2016, her head started to drop down to her chest and that complication got progressively worse.
“All of a sudden, my head started to fall forward, and I couldn’t lift it back up,” said Mrs. Mullane. “I was very worried, but I was also hopeful that it was a fixable problem.”
Months of being unable to lift her chin off of her chest turned into a year, and then close to two years. From April 2016 to December 2017, Mrs. Mullane saw several neurologists and tried many treatments to improve her condition, including physical therapy and massage. Nothing helped.
“I appreciated the doctors I consulted with because they really tried to help me. Unfortunately my condition wasn’t improving. I was feeling more frustrated and discouraged as time went on,” said 75-year-old Mrs. Mullane, a wife of 50 years, mother to four children, and grandmother to nine grandchildren.
“I couldn’t drive to go visit my children. I couldn’t babysit my grandchildren, or even pick them up. I couldn’t eat properly because I had to manually hold my chin off of my chest during meals. My eyes were strained from looking up all of the time,” Mrs. Mullane recounted. “All I wanted was my life back. I felt defeated. I started to accept my condition and I decided to stop going to doctors for additional opinions.”
Yet, just as Mrs. Mullane made this decision an acquaintance from her church gave her a life-changing referral.
“This woman, whom I didn’t even know by name at the time, felt strongly that I should try one more doctor. She recommended that I go to a spine surgeon in Danbury, Connecticut named Dr. Kramer,” said Mrs. Mullane. “When my husband and I met with Dr. Kramer, we were skeptical that he would be able to help given the number of doctors we had already seen. But our doubts went away quickly. Dr. Kramer listened to me and examined me. He was empathetic and supportive. He was also confident that he could help me with a surgical procedure. My husband and I both cried because we were so relieved.”
On December 4, 2017 at Danbury Hospital, Dr. Kramer and his partner , MD performed a complex anterior and posterior cervical reconstruction of Mrs. Mullane’s neck to correct the dropped head syndrome.
The 5-hour surgery was organized into two parts. First, Drs. Kramer and Bomback worked on the front of Mrs. Mullane’s neck. They released her neck muscles and broke up the bone structures in order to restore flexibility. Then, they put wedges of bone, or bone grafts, into the front of her neck to reestablish proper alignment. During the second part of the surgery, Drs. Kramer and Bomback locked the bone grafts into position with instrumentation — titanium rods and screws — in the back of Mrs. Mullane’s neck. Throughout the procedure, the surgeons worked through small incisions, and when the surgery was completed they carefully closed the incisions so Mrs. Mullane’s neck was cosmetically pleasing when she healed.
“Mrs. Mullane’s neck deformity was complex because it had progressed over such a long period of time. The bone structure and soft tissue around her neck became rigidly contracted into an extreme forward flexed position. There was a lot of work that needed to be done to re-establish proper alignment and balance. We had to safely restore flexibility to the bones of her neck and stretch or release the muscles to allow for a normal upright position,” said Dr. Kramer. “It’s like putting braces on your teeth, and getting several years of correction, all in one day,” he explained.
Both Mrs. Mullane and her husband are extremely appreciative of the surgeons’ efforts. “During my surgery, Dr. Kramer called my husband after each step to assure him that I was okay. My husband and family appreciated that a lot. After my surgery, when he told me it went well, he held up my neck brace and said, ‘You won’t need this anymore.’ I was so happy!” said Mrs. Mullane.
Mrs. Mullane spent five days at Danbury Hospital recovering from her surgery. She did not require physical therapy because she did not have weakness or neurological deficits in her arms or her legs. She just needed to let the bones and soft tissue around her neck heal from the surgery. Today, she is back to her normal life.
“I’m forever thankful to Dr. Kramer because he helped me to get my independence back. Danbury Hospital also helped me to heal from my surgery — the nurses and staff were attentive and caring. I’m so grateful for my family too for their continuous love and support,” said Mrs. Mullane.
Dr. Kramer attributed Mrs. Mullane’s swift recovery to her positive attitude and incredibly supportive family.
“Mrs. Mullane suffered for such a long time, so she was very determined to get better. She was prepared to do what was necessary and she set her mind to having a positive outcome,” said Dr. Kramer.
According to Dr. Kramer, Mrs. Mullane has an excellent long-term prognosis.
“As we always do with our spine patients, Dr. Bomback and I took a three-dimensional approach to improving Mrs. Mullane’s neck deformity. We took into consideration how she looks and stands from the front, back, and side. We corrected her deformity on all of these planes, which will lead to a great long-term outcome,” said Dr. Kramer. “We also took into consideration Mrs. Mullane’s goals, her baseline level of health, her support network, and her positive attitude when making our decision as to what the best surgical approach would be in her particular case.”
Mrs. Mullane said the kindness of people when she was dealing with her condition astounded and heartened her, and helped her to persevere in spite of her condition.
“A woman I didn’t know stopped me as I was walking down a sidewalk. She said, ‘You look so uncomfortable. I’m going to say a prayer for you.” At a family event, my relatives posed for a picture with me and held their heads up with their hands so I didn’t feel alone,” said Mrs. Mullane.
Mrs. Mullane realized that while she lost a lot, like time with her children and grandchildren, she also gained a lot.
“I learned not to despair even in the most challenging situations. I learned the importance of never giving up. If I had, I wouldn’t have met Dr. Kramer, and he changed my life for the better. Finally, I learned how important it is to have faith and to keep family, friends, and others in your prayers,” said Mrs. Mullane.