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Old 02-02-2010, 01:02 PM   #1
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bjv1979 HB User
cervical non union

I had i cervical fusion 13 months ago at c5/6. i have had complications since this surgery. Including neck pain and serve nerve damage in arms,chest, and shoulders according to emg. Mostly burning and tingling. The nerve damage had finally calmed down as it actually went away completly for 2 months and now comes back every so often but at a 4 pain level instead of 8 or 9. But now my latest flex and ext x ray says non union. I was wondering if there is a chance my bones might still fuse. I am just mad because i waiting this long for nerve damage to go away and it pretty much has but now i have no fusion. I have noticed that my neck is starting to hurt alot more. Just wanted to know if anyone thinks they can still fuse. I heard after 1 year no more but then i read 18 months or 2 years. my surgeon is hard to communicate with. He nevers gives straight answers. I also had an mri about a month ago and all other levels are perfect.

 
Old 02-04-2010, 10:19 PM   #2
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Re: cervical non union

I am sorry you did not fuse - it does happen in some people. I thought I would include a little info for you so you can try to formulate some questions for your doctor.

The nonunion is classified as stiff or mobile and as hypertrophic or atrophic. The mobility of the nonunion is assessed by examination of the bone and observing whether the unhealed area moves much in response to manipulation. If the unhealed area moves a lot, it is called mobile, whereas if it barely moves, it is called stiff. Based on xrays they classify nonunions regarding whether they show evidence of being hypertrophic (trying to heal) by making new bone versus whether they show no evidence of bone healing and even show indications of atrophy (withering away of the bone ends). Usually, hypertrophic nonunions are stiff and atrophic nonunions are mobile.

If you can ask the doctor which category you fall in that would answer your question about whether it may be possible to continue to fuse.

Sometimes a surgeon will leave the non union alone if the internal fixation is in very strong, but there could be future complications - like screws loosening, or additional wear and tear. If you continue with symptoms they will usually go in and correct and try to fuse again.

Atrophic mobile nonunions usually require additional surgical treatment of the nonunion site, with removal of any dead bone and reshaping of the narrowed bone ends so that good bone contact can be achieved.

Hope this helps!

 
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Old 02-05-2010, 08:38 AM   #3
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markhanc HB User
Re: cervical non union

Hi all,
I was just diagnosed with pseudoathrosis of the C5-C6 area. The top part of the plate healed fine. The bottom part did not. My surgeon gave me three options. One, live with it. Two, try a collar for three months that trys to promote healing of the non-union area. Three, surgery to completely remove the plate, clean the area, and attach new hardware using part of my hip bone. A cadaver bone was used the first time. Do you know if wearing the collar has any type of success rate?

Thanks, Mark

 
Old 02-05-2010, 12:23 PM   #4
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Re: cervical non union

Hi mark, same thing happened with me. the top fused but not the bottom. how long ago was your surgery? what type of symptoms do you have? i don't know about the neck brace healing thing, but i do know if i wear my hard collar for a couple hours while i am at my desk at work my pain goes away pretty much completely so i know there is too much instability in there.

 
Old 02-05-2010, 04:02 PM   #5
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Suzy-Q HB User
Re: cervical non union

Hi,
Just a few thoughts to throw at you as I suffered a failed fusion in my lumbar spine. First, a bone scan would give lots of info about what is and is not going on at your surgery site. Also, have you discussed the possibility of a bone growth stimulator? My surgeon didn't think much of them for the cervical spine but I know other docs do have a high opinion of them. I can tell you that I was happy to give anything a try. Also, it was a full two years before we had xray evidence of a fusion for me. We used BMP (bone morphogenic protein) for my second fusion attempt, as well. SQ

 
Old 02-08-2010, 11:52 AM   #6
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markhanc HB User
Re: cervical non union

Hi there,
The surgery was done in early 2007. I wear a collar at night to avoid pain in the morning. I am going to try a bone growth stimulator ASAP. My doc doesn't sound too positive that this will do much, but I thought I would try. He is suggesting surgery to remove the plate, clean everything up, attach the plate this time with a piece of my hip, instead of cadaver bone, which was used the first time. I have pain all of the time in the top part of my neck, sitting or standing, makes no difference.





Quote:
Originally Posted by bjv1979 View Post
Hi mark, same thing happened with me. the top fused but not the bottom. how long ago was your surgery? what type of symptoms do you have? i don't know about the neck brace healing thing, but i do know if i wear my hard collar for a couple hours while i am at my desk at work my pain goes away pretty much completely so i know there is too much instability in there.

 
Old 02-08-2010, 04:22 PM   #7
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kmur HB User
Re: cervical non union

Was wondering if you are a smoker, as this will cause delayed bone healing.

 
Old 02-09-2010, 12:32 AM   #8
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markhanc HB User
Re: cervical non union

Nope, stayed away from them. I do have type 2 diabetes, diagnosed in 1999. I know that isn't helping the healing process...

 
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