Question
My Husband broke his neck in a car accident in 1997. The neck was prolapsed c2-c3 and broken c3-c4, c4-c5, c5-c6. Being 19 at the time it was decided that he would not have an operation and spent two months in traction. 2004 he underwent a fusion. They removed the c4 vertebrae as this was the most damaged and replaced it with a titanium cage.
This year we have been informed that the fusion has failed.
He is now experiancing loss of feeling in his right arm and leg and is in constant pain he practically lives on a diet of Lentegesic, voltaren, myprodol and local anesthetic injections to the neck area as the muscles are in constant spasam. We both understand that another operation is inevitable but would like some advice on alternative pain relief and any suggestions on what can be done to alleviate the numbness he experiances. He is not able to partake in much sport and even swimming causes pain. Along with this physiotherapy again causes discomfort.

Answer
Hi Nicky,

Sorry to hear about your husband>:(

Unfortunately, these procedures rarely if ever turn out good. It doesn't sound like he had much choice so his options were limited. Same goes for his present issues, conservative management isn't likely to help much either. Cold Laser and electrical stim/TENS Rx can help with the pain, glucosamine sulfate can help with the osteoarthritis and active range of motion exercises can help with function. Aside from that, not much can be done. It sounds like he is lucky to be alive, you need to find a good Physiatrist, Chiropractor or Physical Therapist to aggressively keep what he has. This will include trigger point therapy, passive and active range of motion exercises, Proprioceptive neuromuscularfascilitation (PNF) and other non-invasive treatments. I doubt if he can ever be manipulated or even undergo traction for a long time.

It is impossible to know without a current MRI showing what is currently biomechanically upset, unstable or diseased. If the fusion didn't take then it needs to be repeated until it does or he needs to go to a top teaching hospital where they have more advanced surgical techniques. I would be hesitant to have the same surgeon possibly fail again, try to get another opinion. I wish I could be more help but there isn't much that can be done. Continue doing what he is doing and follow the doctors recommendations and hope for the best.

Take Care,

Dr. Timothy Durnin
drs.chiroweb.com