“The day of surgery, I felt hopeful. I was feeling confident in Dr. Galgano.”

Heinley has worked as an actor since his mid 20’s and is currently pursuing a Masters of Fine Arts at the University of North Carolina at Chapel Hill. While acting in class one day, Heinley took a hard fall. What started out as soreness turned into numbness that traveled down his legs.

When Heinley first went to see his primary care provider suspecting that he had multiple sclerosis (MS), the test came back clear. But as time passed, it became harder for Heinley to move. “While doing a play, I had to move fast and I couldn’t,” said Heinley. “I became less and less able to run. I had a couple of little falls and my knee was giving out on me.”

In February of 2023, Heinley’s symptoms had become so severe that he could no longer walk at a brisk pace, felt pins and needles in his feet, and still experienced daily numbness. “I thought I had MS again, but [the test] was negative again,” said Heinley.

Finally, Heinley met with a sports doctor who he had met through the theater program. “When I saw her about my knee issues, she said we need to look at your back,” said Heinley.

Heinley went to a couple different doctors to look at his back and each assured him that nothing was wrong. An x-ray showed a broken rib, but no abnormalities or injuries in Heinley’s back.

As Heinley went to various doctor appointments, it became harder for him to walk. Despite the increased loss of mobility, Heinley still could not get answers. “I lost the ability to move my toes, and the ability to extend my leg fully,” said Heinley. “Then my foot started dropping.”

In addition to his mobility problems, Heinley also had trouble with bowel movements. He was admitted to the hospital for severe constipation. While in the OR, he was again checked for MS. His doctor then recommended that they look at every part of his back, including the thoracic spine. Heinley went in for an MRI and had a GI appointment for the constipation.

Because Heinley’s symptoms were progressing, he came to the emergency department at UNC Health in Chapel Hill. An MRI revealed a very rare spinal anomaly: a thoracic spinal cord herniation. This is an extremely rare condition where the spinal cord herniates through the natural membranous layers that enclose it. Complex spinal neurosurgeon, Dr. Michael Galgano, was then consulted on Heinley’s case.

Heinley was diagnosed with ventral spinal cord herniation. “The spinal cord herniates through the anterior (front) wall of the dura mater,” said Dr. Galgano. “It is generally suspended by the dentate ligaments and is ‘floating’ within the spinal fluid. When spinal cord herniation occurs, the cord can be irreversibly injured from pulsating against the vertebral bodies in front of it.”

Dr. Galgano recommended that Heinley have surgery as soon as possible, in an effort to salvage as much neurological function as possible. By this point, Heinley was experiencing weakness and numbness from his chest down to his toes. “Dr. Galgano said that I needed immediate surgery to stop the symptoms on the right side and make sure that the paralysis didn’t spread to the left side,” said Heinley.

Two days after his diagnosis, Heinley went in for surgery. “The day of surgery, I felt hopeful,” said Heinley. “I was feeling confident in Dr. Galgano.”

Because Heinley’s situation was rare and his symptoms so progressive, it was difficult to prognosticate the outcome. On August 23, 2023, Heinley went in for surgery. The complicated surgery lasted for seven hours. “I had to open his dura, reduce the herniated cord from the dural defect, then place a synthetic dural sling in front of the herniation to prevent it from occurring again,” said Dr. Galgano. “The sling acts like a hammock for the spinal cord. It is a tense operation.”

Heinley spent one week recovering in the hospital before being transferred to inpatient rehabilitation in Hillsboro, NC. “The nursing staff was super attentive and friendly, and very positive and supportive,” said Heinley.

Before being discharged from the hospital to the inpatient rehabilitation center in Hillsboro, Heinley had to pass a few tests including transferring himself from his bed to his wheelchair. “Those professionals that came in also worked well with me to push me to be ready but also cared for me,” said Heinley. “They were invested in my recovery.”

Once transferred to the inpatient rehabilitation center, Heinley worked with two different physical therapists during his 3-week stay. “Calvin was very careful and very much let’s push you but be careful,” said Heinley. “Amy was more you can do this so let’s do this. Having those two really helped get me to the point where I was ready.”

“When I got to inpatient therapy, we had everything from speech pathology to rec therapy, to help me acclimate to life after surgery. It was a big leap to leave and jump right back into the real world.”

Heinley went into the rehabilitation center in a wheelchair and came out walking with a walker. “I was able to walk without assistance for six minutes,” said Heinley.

Heinley is back to acting and hopes to get his recreational activity back up to where it was before symptoms. His bowel and bladder issues have resolved. “I’m happy to report that I didn’t miss a beat,” said Heinley. “I came out of inpatient PT and returned to school the next day.”

Heinley performed his first role post-surgery in a wheel chair in November of 2023. He starred as the lead in a play, and describes the performance as one of the best professional moments of his life. “A lot of staff came to the opening night of my play,” said Heinley. “When I woke up from surgery, because I had been intubated on my chest, I didn’t have my voice. When I got to inpatient therapy, we had everything from speech pathology to rec therapy, to help me acclimate to life after surgery. It was a big leap to leave and jump right back into the real world.”

Outpatient therapy helped Heinley transition from a walker to forearm crutches. He is currently doing regular physical therapy to strengthen his back and is working on his personal health, and plans to marry his fiancé next year. Heinley recently graduated with his Masters of Fine Arts from the University of North Carolina at Chapel Hill and was able to walk up and receive his diploma without an assistive device. After graduation, he performed in an Off-Broadway production using one forearm crutch. He is currently walking unassisted with the occasional support of a cane. He also returned to short distance driving. “At this point I am probably where I was last March or April, but I’d like to get to where I was in 2018.”

 

Article by: Makenzie Hardy, Marketing Coordinator, UNC Health Department of Neurosurgery