I fell from a horse in Nov 2000. Had an anterior cervical fusion c4-c6 with some synthetic disc replacement and a titanium plate and screws. Did not do well postoperatively - I vomited for 3 days because of the pain treatment. Did not wear a collar or undergo physiotherapy postoperatively - and was back at work after 3 weeks. Had disphagia, severe pain between my shoulder blades and R arm, as well as chronic spasms of sternocleidomastoid and suffered anxiety attacks. Symptoms did not resolve - went for a second opinion in 2002. MRI scan was done - dit not look good. In June 2002 a posterior cervical fusion of c4 - T1 was done with bone graft and wiring of spineous processes (apparantly the upper level of the previous fusion was loose, as well as the level below the fusion). It went very well postoperatively - all the pain resolved and the muscle spasms subsided. No anxiety attacks any more. After the second op I did wear a collar and underwent extensive physiotherapy. Went back to work after 2 months. However, the following symptoms reappeared 2 weeks ago: disphagia, sternocleidomastoidspasm, pain between shoulder blades and R arm pain. I am presently undergoing physiotherapy. I am a Unit manager of an intensive care unit - mostly performing admin work. Did not do any heavy lifting. What can the reason be for returning of symptoms? I am an asthmatic and allergic to certain foods . Is it possible for me to reject any of the synthetic material used on me? Can you please give me any advise on what to do, or what can possibly be wrong? Thanking you. Hettie