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Sherlock and The Missing Bone Graft
Seasons Greetings. Back in 1997 I had a fusion of C-4 thru C-7. At a three month post op follow-up
x-rays showed the graft placed anteriorly at the C6-C7 space had come completely out. My doctor assured me there was no concern as the other locations were "knitting well". There was no instrumentation. I asked if this piece of bone floating around in my body could pose any significant threat then or in the future and he assured me I would be fine. Recently, I discovered a large and very hard knot in the supra-clavicular area, right side. It has become quite painful, sometimes limiting the use of my right arm and causing substantial and radiating pain up the right side of my neck, face and head. Today I had a CT Scan with and without contrast which was inconclusive. Could this be the renegade bone graft? I just assumed the right side discomfort through these years since the surgery was a common side effect of some permanent nerve damage. Thanks for any input and direction. You guys are always right on the mark.
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Hi,
The swelling in the supraclavicular region that you developed recently could be an altogether a new problem. But with the bone graft placed, it can also be considered a sequale of that.
It can be infective material that has been draining out into that region from the sequestrated bone graft.

There are numerous causes for the swelling to appear in this region, commonly being a lymph node which could have been infected.
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A recent ct scan ruled out tumor/lymphoma. I've just been going over radiology notes for a post op follow up in "97" and confirmed that the graft at the c6-c7 location was not visible. The x-rays accompanying the notes which were taken prior to the follow up show that particular graft protruding substantially. The x rays prior to the second surgery of "03" conclude the graft did in fact dislodge
evidenced by a non-union, no graft material present, very narrow disk space and disk material well outside it's normal location. What a mess.
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Hi,
With these radiology reports, it is definite that graft  has dislodged and displaced.A rare complication.
Now since your graft has dislodged, it means that bone graft is out with no blood supply and hence of it becoming is very high. The dead bone is called sequestrum and if it is inside the body,it would form in abscess and later on discharge outside through a sinus.
This could be the possibility. Hence consult your surgeon and seek his opinion on removal of that bone graft.
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Seems what you told me is becomming the overall opinion. You have also helped me further understand why I had so much difficulty in finding information on this condition/complication. The up side is being informed...the down is looking at another surgery even though it is without doubt beneficial. I feel that this also defines the source of a blood infection I had a few years back. Though treated with antibiotics the doctor never did determine the source. Easily understood. I did not know about this to tell the doctor it was there. And I tell my doctor everything. Again...Thanks & God Bless.
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Hi,
Appreciate your feedback.
Feels good to know the information posted was of some help to you.
Have an appointment with your doctor and do post the advice given by him.
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