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Confirmed cracked C6-C7 fusion

jben55jjben55 Posts: 35
edited 06/11/2012 - 7:51 AM in Back Surgery and Neck Surgery
Confirmed from CT scan today that my C6-C7 is cracked horizontally and in a jagged fashion from posterior to anterior. Touching plate, lucky it has not caused plate to come loose. For Tam Tam and Aviatrix, I am being told that surgery is necessary and my OS wants to address posterior with hardware and BMP (bone morphogenetic protein). He is very confident to achieve 100% fusion with this approach in short order. Getting a 2nd opinion tomorrow.

Please reply anyone who has had revision surgery in this fashion and what your results were.



  • Jon,

    That posterior surgery sounds to be the gold standard for revision fusions on the same level. But one question I have is did you fail to fuse or did the fusion crack. Was the graft they used allograft(cadaver) or autograft(your bone). Here is what I now about bmp(bone morphogenic protein). I had it used in June of 08, and in July of 08 there was a official notice put by the FDA and medtronic the manufacture that it is not to be used in cervical spines, except in rear circumstances. So if that is not your bone as part of the fusion, I would be questioning the use of the BMP. The issue with BMP is that it causes, in some cases severe swelling. Sense the surgery is being done posterior the the swelling rate does go down. But I would also ask if they will be giving you sterioids to combat the swelling. The material doesn't stay in your body very long it is more than likely gone before you leave the hospital. But the way it calls all the properties to the area for the fusion also brings the swelling. Now I had it put in the anterior side and had some severe issues with swelling. I will always have some residual issues from that swelling. Now the good news is I was fused in 3 months. But i also fused in three months on a surgery from the posterior side using my bone.

    Yes there is additional pain from your hip bone but having it taken from the posterior side is not near as bad as the anterior side. I would definitely get the second opinion, though as it will help you feel more confident. Also what about the anterior hardware that is already in place are they leaving that hardware? Anyway if there is anything i can do don't hesitate to pm me. Keep me posted.
  • Thanks for the update, sorry to see you have indeed joined the 'cracked' society though! The CT for mine will be to confirm if it is cracked through bone, or the fusion, as x-rays - not clear enough to tell which part went. I don't know if that makes any real difference for me, but they seem to 'need' to know what part cracked.

    Forgot to mention, my surgery was 8-12-09 -C6/7 was added to C5/6. I'm (and hubby feels the same as does my GP) pretty sure mine cracked due to dissimilar hardware (see avatar) and as such unexpected stress on the area between the fusions. I do know if they redo this mess, *I* want my hardware back! No, not for a law suit, but a memento.

    I see my Neuro on Friday. Hopefully will have all my scripts to get full diagnostics done and a follow up not too far out. Thanks again for the update. I of course will be following closely. It's weird, but not counting myself, I think you are the 4th in the last number of months to crack within the C6/7 fusion area. I wonder what's up with that?

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • My anterior work will be preserved including the plate. I don't believe I'm getting any more bonegraft other than to shore up the current fusion with posterior hardware and BMP.
  • My anterior work will be preserved including the plate. I don't believe I'm getting any more bonegraft other than to shore up the current fusion with posterior hardware and BMP.
  • Jon,

    That sounds like a win-win. I was told on mine, they would have to take mine out to fix mine, but too they would be adding a level, so that might be part of it.

    I'm steamed now though. I just got a call from my Neurologist's office, and have been moved to of all days April 1st! Office "Sorry, he's been covering another Neurologist all week".. Oh, and you all are telling me now? She could tell I was steaming. I really like this Neurologist, but come on...

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • MetalneckMetalneck The Island of Misfit toysPosts: 1,615
    Posterior Cervicle surgery is no cake walk.

    I have reamaining pain, stiffness and loss of range of motion. My last revision was about 2.5 years ago.

    It was a revision of a failed anterior 2 level only and is now the lovely mechanical artwork shown in my avatar. 3 level anterior posterior with cage rods vetebrectomy etc etc.

    I wish the best for you sir ... please remember to convelese after the procedure. Give your body time to heal!!


    Spine-Health Moderator
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    I am not a doctor nor have I ever played one on TV.  Therefore any comments made are based on my experience.
  • So I got my 2nd opinon yesterday. Quite different than my Surgeon's. Both concur I have non-union, however where they differ is that while my Surgeon says this is recent, 2nd opinion stated I have never fully fused. 2nd opinion does not want me to rush into surgery, but rather wait this out. Further, that the graft is not in danger of causing the titanium plate to come loose. I told him that I have been in intractable neck pain for the last 6 weeks, he says that's not that long that this could work it's way out and perhaps I should go and get an injection for the time being.

    While I appreciate knowing my situation is not perilous or imminent requiring surgery, nontheless, his finding does nothing to give me any certainty if the fusion will ever fuse on its own and for that matter how I can get out of neck pain sooner than later. I am little baffled at the extent of difference of opinion from 2 Dr.'s that know each other and trained under same tutelage.

    So I am presently waiting to schedule a Facet Joint injection, but am I only prolonging the inevitable? Bottom line, I want to be fused. So what to do?

  • Jon,

    When I cracked mine, I was put on a "lets see if it resolves on its own" for a year or more! Mine didn't resolve, and now it's 15 months post crack. That is why I am back with my Neurologist to now put a plan in play. Don't be surprised if they put you on hold for 6 months to a year to see if the bone and crack resolve on its own. I know it bites, but if there is no imminent danger, better if it heals vs surgery.

    At least that is what 3 opinions resulted in for me. It can take a year or more to fuse....

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • in the interim. I need some level of relief to function better. I'm geting through the days but my quality of life right now blows. I'm lucky I have a fantastic wife, family and a beautiful little girl but I need to get back to full-functional ASAP for my own sanity.

    I'm sure its rough for you too. Hang in there.

  • Jon,

    Oh I hear you big time!! The movement on mine is in just the right position such that it screws with my vocal cords. It would be nice to be done with choke out! Most of my pre-surgery symptoms came back, and are affecting both arms now - the right more than the left, add that C7/8 going. Yes, relief would be very well received on this end too! (G)

    I hope the shots work for you. They did nothing for me. Fingers crossed for you. Even though your opinions don't agree, at least you're starting to get answers, which is good - they know there is a problem.

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • What causes a crack to occur? I am still waiting to see if there is bone growth as I am only 12 weeks post op. I did notice that the screw in one of the vertebra is off centered and I am concerned that it is too close to the edge. I figured that they would be centered to avoid a crack. I'm not saying that I think I am cracked, maybe my mind but not my vertebra. Just curious.

    12/9/2010 ACDF C5-6 C6-7
    DDD, severe arthritis
    4 hours with a bone stimulator per day
    no bone growth yet (6 week check)
    3/14 3 month check. . . hoping for bone growth
    PT starts Monday 2/21) had eval prior (painful)
    Went to work as a teacher 2/14/2010 exhausting
  • SpineAZSpineAZ WiscPosts: 1,084
    Posterior cervical surgery can be a bit more painful than ACDF so just be prepared for that. I'm facing revision to add C4 to my C5-C7 and I told the surgeon I feared posterior if necessary. He actually said it's odd but some of his posterior cervical patients report very little pain while others say it's much more painful than anterior, so I guess it differs by the person.

    If I personally could see my crack and any displacement on an xray or MRI I'd agree with my surgeon to fix it. I think I fear the displacement. If just a crack was found and it was not displaced and not causing symptoms I might agree to give it more time. But if there is displacement causing nerve impingement a shot (ESI) may mask that pain but not fix the problem. Maybe a 3rd opinion?
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 

  • Seeing that, from 2 surgeons you have two different opinions, how about trying another opinion to see if that would agree with one of the others?

    Also, take along a list of questions of what ifs.

  • I know for mine, the feeling is due to dissimilar hardware (different stress directions between them). I knew mine was also moving due to losing my voice all the time (5 months post op it happened), choke outs. My ENT suspected hardware, but when he saw the x-ray, he revised that to movement at the crack.

    Another reason it could crack is if you had a partial fusion, the fused area is weak, and can crack. Or, not fully fused and the hardware loosens, weak areas within the fused area could conceivably cause a crack - not common.

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Spine AZ, thanks for comments. Agree with 3rd opinion, particularly as each weekend approaches and I am absolutely miserable and unable to enjoy. I initially respected the 2nd opinion of not rushing into surgery and trying to wait this thing through, but I'm in way too much pain to tolerate. Regarding what is known, I could see the crack or what looked like discoloraton of the graft and it looked like it was up against the plate when my Surgeon showed it to me via CT Scan. I am very symptomatic with excruciating neck pain and headaches. I'm a least sleeping now due to Ambien, but that's not good enough quality of life for me or anyone I would imagine. Now why my 2nd opinion did not see the same thing despite being a highly regarded surgeon in Southern California, I am baffled particularly since these guys know each other and trained under the same tutelage. I'm beginning to think my Surgeon's original opinion was the correct one, but what remains unanswered is how a Posterior approach would address a crack and/or displacement of the graft - I guess because of additional stability. I'm getting the Facet Joint shot to buy some time and get some immediate relief if possible. I do have a 3rd opinion scheduled for the 16th of March. Hopefully this helps in my decision bmaking.
  • I used to have United Healthcare with my previous employer. They approved the ADR in my lower back even before it was FDA approved. I have never had a problem in my lower back since. Unfortunately my current insurance Anthem Blue Cross denied the cervical ADR in 2009 stating "experimental" and approved instead my ACDF - 2 level. I often wonder now although it doesn't help the situation that if I had a cervical ADR would we even be discussing my present situation.

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