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non-union after cervical fusion

  I posted a message on 8/14 under the topic conflicting opinion..No reply to date, but this is an update to that message. I saw the neurosurgeon that did the fusions of C4-5-6-7 about 30 months ago. He had an x-ray done by the group that followed me post surgery and says that it looks like the fusion at C6-7 is not good (there is movement). He said that attempting to re-do the fusion is a possibility, especially where I have symptoms and have  been degrading in the past 6 months. A different neurosurgeon doesn't believe in fusions , thus would never have done fusions in the first place. Besides my trust in the doctor, how do I make an intelligent decision on this one?
Dear Dave,
Sorry we didn't get to your question earlier.  You have had a multi-level
cervical fusion in the past, and one level seems to not have fused.  Presumably,
your present symptoms are from that level.  Symptoms at C6 from nerve compression
would include numbness and pain in the middle finger of the hand and weakness
of the bicep muscle.  You may have pain from an unstable cervical spine at
that segment as well.
An important issue is how much the symptoms interfere with your daily activities.  
If the numbness, pain and/or weakness aren't that bad, you may choose conservative
measures to see if you get better.  The bones at the level of a previously
failed fusion will often fuse, but only after a protracted period of time.  
This can be too much for some patients.  If your symptoms are limiting your
activities and quality of life, then another shot at surgery may be a good
You do have an increased risk of non-fusion at that level due to the previous
failure, but a good spine surgeon should be able to take care of you.  Also
note that smoking and diabetes will increase the risk of non-fusion.
Speak to your surgeon in this regard, as these are issues very pertinent to
your life.  The issue is really your own quality of life.  We would be happy
to see you at the Cleveland Clinic if you so desire.  An appointment can be
made to see a neurosurgeon that specializes in spine by calling 800-223-2273,
ask the operator for the neurosurgery scheduling desk.
Good luck.

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