C1 and C7 Neck Fracture - Treatment Options

[KS27092008]

Hi,

History: 25y/o white female, car accident Sept 08. LOC ~10 mins, no seizure, no vomitting, c/o neck pain, full spinal precautions. CT showed Fractured C1 posterior arches, fractured C7 vertebral body and left C7 transverse process , disruptions to the C6/7 left facet articulation. C7 vertebral body 3mm posterior displacement/retropulsion. Fracture of C7 spinous process. Clinical signs of C7 weakness - MRI showed C6/7 forminal narrowing, no SC compression, no brachial plexus injury. I was fitted with a Miami CTO brace and allowed to go home after about a week in hospital. I have no pain associated with this injury, only minimal tingling in left index finger and left triceps weakness.

It has been 10.5 weeks since the injury. I have a CT scan in a few days and fear that the C7 fracture has not healed (I can still hear a grating type noise). The CT at 6 weeks showed a very visible gap in the vertebral body, significant of minimal healing. The spinous process appeared to be healing. I see my neurosurgeon the following week and would like to be prepared so I can ask as many questions as possible. I am not keen on surgery.

What are the treatment options if the scan reveals that there is still not much healing?  
What can be done other than a spinal fusion (C6/7 in this case) / ie non-surgical?
What is the suggested amount of time allowed for neck immobilisation before surgery is recommended?

Can healing be sped up (ie I am taking calcium and a multivitamin to ensure RDIs are met and maximise the potential for bone growth, ultrasound therapy)?

I am fairly active (I dance - ballet/contemporary, jazz, tap - and play basketball) and would like to preserve range of motion if possible. How limiting is a C6/C7 fusion to cervical ROM?

Thanks,

KS27092008

[stanslaton]

I had a bicycle accident 2 months ago and fractured 5 ribs and had a hairline fracture of C7. I was put in a hard collar which I have worn 24/7 and only take off to shower or just let my neck breath. I just had another CT scan and it shows the left portion of the fracture showing some stenosis or healing but the right portion of the vertebrae which was a hairline fracture is now a 2cm fracture, so it has gotten substantially worse. My neurologist gave me two alternatives and one is to continue to wear the collar for two more months while the other option is surgery to pin the vertebrae, remove the plate from a previous surgery at C5-C6 and add a new plate to cover the 3 disks. This cannot be done from the throat area like my previous neck surgeries which were ruptured disks, but must be done from the back which means cutting through muscle and a much more extensive procedure and rehab. Anyone else have experience with this type of procedure?

[Alfie1234]

I fractured my c7 in a car accident in 2011, i have a slipped c6/7 in my neck, im in constant pain.. I have constant painii down my left arm, numbness in two fingers... I struggle with lifting things ie shopping etc. And because iv become dependant on my right arm this now has pain. I have had physio.. God knows how many mind blowing medication. And still no better off. Iv been to see a neurologist who said i could end up paralysed.. As there is always a risk..but medication is only option. IM 39! And feel 89 most days. IM self employed and struggle day to day. The headaches are unbearable. But like the rest of the comments we just have to keep popping the pills. Which send me loopy. As i type this im in agony, as i hoovered and mopped before i left for work...

[inpainandfedup]

I have been lurking in here and reading the other comments...I have a story for ya...I was in an auto accident four years ago on my son's fourth birthday, I started having headaches, nausea, lightheaded and dizziness almsot immediately then my neck really started hurting. When cops and ambulance came, I was put in neck brace as precaution and brought to hospital, where low and behold everybody from the er til current has told me "there's nothing wrong with you, we're not sure why you are complaining of pain....but here is some pain pills and muscle relaxers, hope these help" and continuously passed the buck so to speak onto the next doc in line. I finally got to a chiropractor, thru my atty's office coincidently, and he said i had a healed fracture in my neck with reverse curvature of my neck, compression in the discs, (which is what is causiing my pain) a twisted spine, and a herniated disc in my lower back. I've been out of work for over two years due to this, I can't sit/stand for any length of time without paying for it, no lifting, bending, twisting, etc and unfortunately am dealing with attorneys and disablity. I was asked which I will ask in return, what can be done for my neck now that it's happened and improperly healed?

[netterose]

I cracked c1 and broke c7 I have been out of collar for almost a month now I wore it for 2 n a half months..my head has horrible crakin noise when I move..does anyboy else get this..u can email me @ ***@**** thanks

[JaySupreme]

I am 24 years old and suffered a fractured C-7 around 4 years ago. The worst part is that I I cannot pin point when it occured. I used to be very active in Basketball, Football and rough play here and there, so somewhere along I take it this happened. I began suffering from HORRIBLE upper back/neck pain and tensions. I spent 3 years going from primary doctors, to neurologists, to orthopaedics with all of them telling me it was JUST SPASMS! Finally an orthopaedic surgeon found through a simple xray what no other seemed to care to even pay attention to, a FRACTURED C-7! Well, from orthopaedic surgeon I moved on to a Neurosurgeon since even the orthopaedic told me to live with it and nothing I could do, GREAT!! So in conclusion, my Neurosurgeon recommended to remove the fractured/loose part of the C-7 which was causing my nerves to be constantly pined with every movement. I underwent this surgery March, 2011 and even though it was an outpatient surgery, the recovery was very rough. YOU WILL NEED FULL CARE FOR ATLEAST A WEEK. After the surgical recovery and the use of a soft neckbrace, all my horrible pre-surgery symptoms began to go AWAY to a recovery of about 90% of before the fracture. I felt like I was born again! But unfortunately, after slowly getting back to work and one rough day, the pains and inflammation all have returned. It has been near 8 months since my surgery and my Neurosurgeon tells me when I go back every 3 months to give it time. I Have an appointment early November, I really do not want to hear, give it time anymore. I pray he has another answer to try and fix me, I too do not want to live like this my whole life. I am tired of complaining about this pain, tension, and extreme discomfort on my upper back and neck. As the previously stated, I can vouch to say the ONLY thing keeping me going is my Chiropractor! With therapy of heated water beds, traction chairs and frequent adjustments, I can go on descently for a couple more days before I need to go back. It still ***** because its practically a temporary fix but the adjustment of upper back and neck Really take away most of the tension on my neck. In conclusion, the "Specialist" to see for a fractured C-7 is a Neurosurgeon, and for treatment and management, see a Chiropractor. Do NOT WASTE your time at pain management centers or endocrinologists, and epidural shots directly on your neck/spine do NOT work! I tried 3 Seperate shots, it was the equivalent of taking 2 aspirins. Well even though I am still going through it, I hope I was able to help anyone suffering from these horrible fractures.  

[thelastconsumer]

A year ago I was rear-ended on my 30th birthday and fractured my C7.
I spent months in a cervical collar followed by physical therapy (hot packs, soft tissue massage and neck muscle exercises) and I was left with a doctor telling me the fracture is healing and that I will be fine.

Well, the headaches (truly unbearable ones) continue to this day. The only relief I have found is from a chiropractor. That said, it was only my first visit to the chiropractor that made any noticeable impact. The first correction I had done removed a swollen lump of muscle that I had previously named the headache button. This one visit cut the amount and intensity of the headaches down significantly, but they are certainly not gone. So, I recommend the chiropractor but it does not solve everything.

I was an active person (a backpacker and canoeist) before the accident which has been pretty heartbreaking to live without. But, the biggest problem with this injury for me has been the effect it has had on my work. As a graphic designer, I work on the computer all day. Of course working on the computer is the number one trigger of my headaches... add some stress and you get nausea too. I have started and quit two jobs over the course of healing because the pain was unbearable. I am stuck working a low paying manual labor job to avoid the pain.

I had another CT scan today to make sure that the fracture is indeed healed. I am sure the doctor is going to tell me it has and that I should not be in pain anymore. Anticipating this, I am looking for a second opinion today..... but I think I know what the answer is going to be.

I don't think anti-depressants will do anything but help you cope with the depression caused from inadequate medical care. I tought this was just some weird fluke with me... I can't believe others are going through the same thing

[Julesmono]

I to am a 30 yer old i rolled my mini over 6 weeks ago and had broken my C6 & C7 spinal proces and my back, T4, T5 & T6 back bones they seem to be healing well but my C6 & C7 are very slow i have been in a hard neck coller for the last 6 weeks 24 hours a day and last week at my scan i was told i can take my coller of every other hour for an hour to build up my neck muscles, it is really painfull and unbearable. I to was very active and am going stir crazy with boredom not been able to work ect. I to get really bad headaches what have you been recomended to do in this situation?
Julie

[Cheri15]

I was in a car accident on 11-21-06. It was shown that I fractured C6 and C7 in my neck. I spent two days in the hospital and they released me. To this day, I am having severe headaches and mild to severe neck pain. Every doctor that I go to is telling me that nothing is wrong and puts me on an axiety drug or an antidepressant. The pain is real and hurts so bad at times that I can't move. There is swelling present at the base of my neck. Does anybody have any advice. I am 30 years old and do not want to live with this pain for the rest of my life. I want to be active in my childrens lives.

[LLWB]

I don't know exqactly how long it would take to heal, but if it isn't showing signs at the next CT Scan, I would consider surgery. If left untreated, the numbness, tingling, and weakness could become permanent. I had C5-6 fused over a year ago. They also removed the disc, and put in a titanium plate and screws. I have as much, if not more, ROM than I did before the surgery. While surgery is not pleasant, it may be your best option for a full recovery. Good luck.