
Originally Posted by
Mellie
Good Evening,
Last week, my aunt had two falls - one at home and one at a hospital near her house. After an MRI at the hospital, they determined that she had fractured C1/C2 and she was transported to a level 1 trauma center. She doesn't have spinal cord involvement and I know that this is an SCI forum but I was hoping that I might be able to benefit from the wealth of information here on the forum.
I met with the neurosurgeon, my aunt, and other members of my family last week to discuss treatment options. The neurosurgeon strongly recommended a halo but gave us the option of fusing C2/C3 due to ligament damage between the two. We all agreed (my aunt, family, myself) to do the fusion. My aunt is only 55 but she has rheumatoid arthritis and was preparing for a knee replacement so she's a bit shaky on her feet and we wanted to take a more proactive approach with this.
Surgery went well and a screw was placed between C2/C3 on the anterior side and some donor bone was grafted onto the fractures on C1/C2 to help promote healing (I think I'm explaining this right). She was off the vent about 24 hours after surgery. However, when they took x-rays on Friday there was still too much movement in her spine so they made an adjustment to the halo.
Today, the nurse called and said that the neurosurgeon wanted to meet with a family member to discuss the next plan of action. Even after the halo adjustment, there was still quite a bit of movement. His main concern was that bones that move aren't going to heal as readily and this is in the hospital...in the ICU...after an adjustment. His recommendation was to do a posterior fusion of C1 to C3. After showing us the CT scan of the supine and upright spine, it made the decision easy and so my aunt signed off on the consent. She'll go in for the fusion tomorrow morning.
Although I'm just "the niece", I'm the information junkie in the family and so my aunt has asked me to be involved in all of the doctor consults. After speaking with the neurosurgeon today, I found out that the fractures are from an extension instead of a flexion and that there is ligament disruption between C2/C3 and a plate fracture and lamina fracture of C2 (I had no clue there were different types of fractures but there were several distinct fractures in C2). I can't read my writing (I was writing quickly) but I think that C1 is a posterior apical fracture...?
Anyhow, I'm rambling and I apologize. I'm on information overload. My aunt's biggest fear is paralysis and so I'm trying to find resources on paralysis percentages after fusion/halo (aside from the risk of surgery). I am a college student so I have access to PubMed so if you know of a resource in a peer reviewed journal, I can look it up.
If you've made it to the end of my rambling, thank you.