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****Posterior c4-c5 fusion even though i have NO pain

scni0502sscni0502 Posts: 5
edited 06/11/2012 - 8:39 AM in Back Surgery and Neck Surgery
i was in a car accident and i fractured c4. now the neurosurgeon says i need a posterior fusion because of what he termed "ligamentus" injury ( i think). i feel perfect, i have full range of motion with no numbness or pain and i work out every day. on the mri i can see the little misalignment that the neurosurgeon is talking about but is that something i absolutely cannot fix without surgery? i would greatly appreciate any advice/comments. i'm in the process of deciding yes or no to the surgery. spinal cord injury is NOT something i want to mess around with but i'm worried because i desperately don't want to put screws and plates in my neck unless there's no other option.


  • SpineAZSpineAZ WiscPosts: 1,084
    Do you have access to the exact diagnosis and/or MRI findings? That may help us help you.

    There are often times after accidents where surgery such as your doctor suggest are necessary even in the absence of pain. Is he saying this is ultra-urgent? If not then get a second opinion. But if he is expressing concern of possible permanent spinal damage then you may want to act fast.

    If you have a misalignment that is unstable any further trauma (even minor fall) could lead to permanent damage. I don't want to scare you but if you have enough of an instability that could lead to spinal cord impingement down the line - your problems would be far beyond pain. Neck injuries to the spinal cord at that level can lead to paralysis.

    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • Get a second opinion from another NS/OS as soon as you can.
  • clinical history: cervical fracture and ligamentous injury

    findings: The vertebral bodies of the cervical spine appear to be normal in height. There may be a tiny amount of anterolisthesis at C4-5 measuring only 1 or 2 mm. There is slight splaying of the posterior elements at C4-5 and possibly some subluxation of the facet joints.Findings are concerning for a ligamentous instability. Right paracentral disc bulging or shallow protrusion at C4-5 causes mild compressive effect upon the right ventral cord. No intrinsic signal abnormality of the cord itself. The craniocervical junction is normal including the odontoid process which is intact.

    impression: Slight focal kyphotic angular deformity at C4-5 with splaying of the posterior elements and slight subluxation of the facets. One to 2 mm anterolisthesis of C4 in relationship to C5. Findings may suggest instability at this region due to previous trauma.
  • sorry, i didn't notice i had any replies until today.. hopefully the mri report gives some insight into my situation. i'm still looking very hard for alternative treatments to strengthen/possibly rebuild the ligament without surgery.

    so i have another question...if i get the surgery (which involves no fusion, just plates and screws) what will the long term effects be?? will my neck still be very vulnerable or would it be almost back to normal again?
  • If you have hardware put in - it should be pretty darn stable - at least that's what my NS always told me.
  • Hi! I had a fracture in my cervical spine which I learned about in 2006. I can't say I'd been in an accident although in 2000 I was in a building with concrete floors (and a thin rug) and a lady hit me in the head with her hand and I fell back onto the floor was out for about 30 minutes. No one thought to call 911...can't understand why.

    In any case, when I saw the neuro he said that because of the fracture, the healing was causing more bony growth that would eventually be a problem. I chose to not have surgery then, lacking confidence in my neuro. About a year later I started having muscle spasms in my arm, severe headaches, weakness and tingling in my left hand. a 2nd MRI showed that the space for my spinal cord was greatly diminished and nerves were being trapped. I had surgery Nov. 6th with an orthopedic surgeron who I really trust and connected with. I don't regret the decision. Every day is different, some good, some not so good.

    The deal is...get a 2nd opinion. The spine and the nerves are nothing to play with. Some nerve damage can be for life and we sure don't want to get there. Hey...it could be an over zealous first opinion or it could be spot-on and save you a lot of pain later.

    Just my thoughts. In whatever you choose, I wish you the best! Have a great holiday.
  • thanks again for the advice...i got the second opinion which helped a lot. it seems i have a slight "kyphosis" or misalignment between c4 and c5. It is dynamically stable but fusion would fix the alignment issue and prevent long-term damage. My fears of creating a weak spot in my neck by adding screws and plates have been put to rest and I've decided to get the fusion. I'll be sure to post the results of the surgery when it's complete. These forums need more success stories!!
  • Good for you, getting the 2nd opinion! It never hurts and now you have peace of mind.

    come back and post. Let us know how you're doing!

  • I wish you the best of luck and I think your doing the right thing. You do not want to mess with your spine. You did the right thing by getting the 2nd opinion and the fracture would cause you more problems later. Fixing it now while your young is your best chance for a good outcome also. I recently had a posterior laminectomy at C3 if you want to PM me for any after surgery advice or questions. :)
    2005-ACDF with Corpectomy at C3-C-5.
    2006-L4-L5 diskectomy.
    2009-Cervical laminectomy at C3.
    Steroid injections series x 4.
  • got the surgery done 3 days ago..they kept me in the hospital for 2 days after the surgery because the post-op is pretty F-ing painful. Everything went perfectly though!! It's only 3 days after the operation and I'm moving my neck around with only minor pain. I'll continue to post my progress until my fusion is totally complete but so far I'm extremely happy with the way things are going!
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