subluxation and small fracture

[Jim]

I'm a very active and fit 47 year old that lives to play.  last tuesday I took  a nasty headplant while skiing.  I hit on the top of my head and got a sharp pain that ran from my neck to the index finger of my right hand.  The arm was numb for about 5 minutes.  I got myself together and skied off the hill and drove home.  I was active the next day and just had a sore neck.  The following day I went to the local e.r. and x-rays showed a subluxation of c-5, maybe about 3/8 inch.  I was sent to a neuro surgeon who did a c.t. which showed a small fracture in the facette and laminae of c-5&6.  He wants to do an anterior fusion of 5-6 with a plate and discetomy.  I am scheduled for a mri tommorrow.  Isn't there a more conservative approach?  I feel pretty good just some moderate neck pain ( I'm now wearing a soft collar ) and no apparant neuro problems.  two years ago  I was diagnosed with a herniated disc at c-6,7 with weakness in my right arm.  A different neuro surgeon wanted to do a fusion but I opted for physical therapy which worked.  I read all the horror stories of failed fusions and I am frankly scared of surgery.  Any help will be appreacited.  Jim

[CCF Neuro[P] MD, RPS]

Dear Jim:

I hope that the surgery works out.  I could never get that telemark turn down very well.

CCF Neuro MD

[Jim]

I'm now three days post op.  Fusion was done of C-5,6,7.  anterior with bone and plate, bone from my iliac crest.  Things are going well I'm in a soft collar and stitches will be removed next week.  Thanks for the advice, medical and skiing, however I telelmark so the front of my boot becomes the bottom when I'm cranking.

[CCF Neuro[P] MD, RPS]

Dear Jim:

Sorry to hear about your head plant and subsequent spinal column problem.  There are several short term and long term problems that may arise with a plate.  I think that this should be the last option tried in a very active person.  Wait to see the MRI and the tissue involvment.  Then sit down with the neurologist and neurosurgeon and see what your options are. If what you hear is filled with dogmatic statements of "must" can "have to" then I would listen, take notes, and then see another neurosurgeon.  Bring all the films and workup and see if the opinions match.  If you need this type of surgery, then bite the bullet and do it.  However, if another opinion is rendered, then weigh the pros and cons and make an informed decision.  I have seen too many screws come loose and fractures around a plate or device to think that there isn't another way in certain instances.

Let us know how it turns out.  Next time, be sure to keep your hands in front of your body, ankles feeling the front of your boot, and skies edged (I used to be an instructor at Alta, Utah).

Sincerely,

CCF Neuro MD