Fusion Failure Problem

[Kikko]

25 yrs ago I had a cervical laminectomy.  3 yrs ago I had a multi level anterior fusion with plate.  Xrays and MRI show that one of the bottom plate screws is angled and through the disc below and not attached to any bone.  I have been told this is going to fail. Somedays I can't stand the pain, other days I can live with it. I was told I should take my pain meds at least 3x day everyday. I don't do that, as I do not want to become addicted.  I also been told by 2 ortho/neuro surgeons that this is a very difficult problem to repair. My neck is tilting forward. My question is: what happens when a fusion fails, what can I do to prevent further damage, will wearing my Philly collar help me? Can this eventually cause paralysis.  I also have swallowing problems that show on the barium swallow test a lump in the area of the plate where food lodges and causes me to choke. Is this also related to the above problem?
Thank you for your reply.  Kikko

[CCF-Neuro-M.D.-PW]

The fact that the screw is not all in the bone can make the fusion more likely to become unstable. Pain postoperatively in this setting is from instability of the cervical joints - ideally fusion should make the joints completely stable/fixed.

The management is conservative (ie no surgery) unless the screw dislodges and causes problems like swallowing difficulties - this can be identified on a plain xray. A dislodged screw should probably be removed as it could cause some damage to surrounding structures like the esophogus. This would require surgery to remove the hardware.

[Kikko]

Is there a reason why the Doctor did not answer my question????  It looks like it was skipped right over.
Kikko