New to forum.
When I was 17 (now 50) I was in a car accident and suffered a concussion and a sprained neck (a misdiagnosis). About 8 years ago I began to have chronic headaches and was eventually diagnosed about 3 years later with occipital neuralgia due to a nonunion fractured odontoid with instability. I was able to manage the pain with PT and stretching/strengthening exercises since that time. Several months ago the headaches returned with a vengeance. PT has failed (neurosurgeon advised to stop PT) and any exercise just makes them worse. I've since had 3 opinions.
Relative to those taken 5 years ago, recent flexion x-rays and a CT Scan indicate increasing instability and a partial fusion according to a neurosurgeon and an orthopedic surgeon who are both in agreement. They both recommend C1/C2 fusion with the wires and screws as treatment to prevent gradual myelopathy and paralysis due to re-injury. A chiropractor saw no instability based on x-rays alone. He did not (or could not) read the MRI's or CT Scans and recommended to avoid any surgical treatment.
Both the neurosurgeon and the orthopedic surgeon stated that they can do the C1/C2 fusion. However, they both recommended to consult a highly specialized surgeon who can perform a direct screw fixation (one or two screws into the dens only) which is much less invasive and preserves mobility. I am currently in the process of scheduling a consultation with another surgeon regarding this option.
I knew that I would eventually come to this bridge and now have to decide whether or not to cross it. I am not ready to throw in the towel regarding conservative management of the pain. Part of me says don't get the surgery since I've lived with the fracture for about 33 years. However, I am very concerned about injury to the spinal cord if I choose to do nothing. As well, I would gladly have either of the surgeries to alleviate the headaches but remain concerned about the long term negatives (i.e. many years from now) of either of the surgeries. I don't want to trade one problem for another though. The surgeons have warned though that things will only get worse going forward and the older I get my options decrease and so does the probability of a successful outcome.
I would welcome any and all comments regarding my dilemma.