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Neurology (Expert Forum)
Failed Fusion Graft
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Failed Fusion Graft
by Kikko, Dec 03, 2003 12:00AM
Last year had a multilevel cervical fusion at C3-4 and C4-5.
C3-4 did not take and now the bottom screw in the plate has slipped and is pressing on the lower disc. If I do not have this repaired, could it cause further damage? It does hurt to turn my head in either direction and to bend it backward. The neurosurgeon said I need to consider a complete cervical stabilization posterior and repair anterior. I did have a cervical laminectomy over 25 yrs ago, and now my neck lost its normal curve and head is heavy to hold up. The posterior surgery will depend on whether there is enough bone left from the laminectomy. I am to have CT to confirm this. But in the meantime, I am concerned about that "loose screw". Thank you
C3-4 did not take and now the bottom screw in the plate has slipped and is pressing on the lower disc. If I do not have this repaired, could it cause further damage? It does hurt to turn my head in either direction and to bend it backward. The neurosurgeon said I need to consider a complete cervical stabilization posterior and repair anterior. I did have a cervical laminectomy over 25 yrs ago, and now my neck lost its normal curve and head is heavy to hold up. The posterior surgery will depend on whether there is enough bone left from the laminectomy. I am to have CT to confirm this. But in the meantime, I am concerned about that "loose screw". Thank you
Doctor's Answer
by CCF-Neuro-M.D.-CS, Dec 07, 2003 12:00AM
Depending on where the screw is it could press upon other structures. Therefore, if it is near nerves, or the spinal cord I would think it would need to be removed and repaired. I agree with obtaining more imaging to evaluate the region. I would recommend having a consultation at a spine center so that a thorough evaluation and opinion could be rendered regarding the best surgical therapy. Without reviewing your films it is difficult to recommend a particular technique. Good luck.
complication although my nuerosurgeon does not seem to think so. X-rays taken just 4 days after surgery show that the lower screws of the plate are not on the vertebral space but in the C6-7 disk space. Another x-ray was taken last week when I went to see the surgeon for continuing burning pains on my left shoulder. This x-ray (6 weeks post-op) clearly showed the plate had moved out towards the esophagus by about a quarter inch. The screws at the top of the plate are in C4 but there is little bone mass above it. The screws at the bottom are between C6 and C7, more or less resting on C7.
To say that I am concerned about this is putting it mildly. I am
petrified.
My nuerosurgeon does not seem to think it is a big deal but evry web site I went to identifies this as a complication. Is there someone out there who has been through a similar experience? Will someone please answer some questions I have like:
1. Should I go for a resurgery and take the plate out? It is
certainly not fixed at the lower level as it is easily moving around.
2. What are the complications in resurgery?
3. Is it easy to remove the plate? Should it be done early or can it wait?
4. If there is fusion and if the plate had been fixed correctly,
there would be no stress on the plate. But now, even if there is
fusion between C4-5-6, C6 and C7 can dispalce relative to each
other. This would put stress on the screws and plate as I move my
head. Sooner or later it will weaken the screws/plates. How long do I have?
5. My continuing shoulder burning pain, could it be because of the screw in the C6-7 space? What other complications can arise from screw in this space?
I am sorry I am not exactly replying to the previous posting but
my problem is somewhat similar and I would like to know if anyone has been through something similar and what they did, also, is there anything about this in the archives?
Appreciate any posting on this and the previous one.
Sam