Spinal Fusion #3

Let’s start off on a positive note! The shunt I had put into my brain to drain my spinal fluid has been phenomenal! We have adjusted the settings slightly, but we are at a good place now and I have been so happy with it! My headaches when laying down or bending over are virtually gone and it has been such a relief. I thankfully have not had any complications with my shunt at all, which has been a huge blessing!

I did end up having my fusion revision back on 4/30/18 (about four months ago). All things considered the surgery went really well. The plan was to replace the cervical screws on the left, which we knew from imaging were loose, and then extend the fusion down to C4. Previously the fusion was down to C2, but since we had failed twice at getting a stable fusion on the left we decided to go down further to try to anchor the fusion better. Our hope was that we could still leave all of the right side hardware in place since it was so stable and just add on to it in order to extend it.

When my wonderful neurosurgeon got into the operating room plans changed just a little bit. It turned out that the skulls in my skull on the left side were also very loose. The surgeon had to take those out and replace them in a new location on my skull (the third spot now). I also had a congenital fracture/deformity on my C3 vertebra. This is not a big deal in itself and did not cause any structural issues, but for a fusion you need to place hardware two level below the instability. For this reason, we ended up needing to extend my hardware down to C5 instead of C4 as we initially had planned. We were able to leave the right hardware intact and just extend it down further, which was what we had hoped for!

The surgeon was very happy with the surgery and we were hopeful that this would be the last fusion I would endure. Unfortunately, less than two months after this surgery (6/29) I was rear ended while on my way to a doctor’s appointment. It was an extremely minor accident. My car needed some cosmetic repairs, but was not too bad off. My service dog was scared, but physically absolutely fine. Any other healthy adult would have been just fine. Me? I spent the day in the emergency room. Although it was just a tiny tap and I had my cervical collar on we needed to make sure my neck was ok. Now the rods and screws we put in during the surgery are like a scaffolding. They are there so that bone can grow on top of them and the bone is what causes a solid fusion. Bone growth is a lengthy process that can take a year or more to be completed. So at not even two months out the bony is no more solid than Jell-O. It does not yet hold anything together. The concern was that the impact could have loosened one of the screws since the bone isn’t solidly holding my fusion together yet.

Well, they did an x-ray in the ER and it looked different from the x-ray we had done post-op. The next step was to do a CT scan. Unfortunately, the CT scan did show that the screw in the C5 vertebrae on my left had changed position. It wasn’t clear how much, but thankfully we were able to wait for my surgeon to get out of the OR with another patient so that he could view the scan. He felt comfortable with sending me home and just watching the screw’s position over time.

I had a follow up appointment with my surgeon the beginning of August. We did more x-rays on that date. The good news is that the screw did not change positions from the end of June to the beginning of August. This means that the screws positon in not progressively getting worse. The bad news is that we are not sure what this change in position means. Since the screw is at the bottom level and is used as an anchor it could cause the whole construct above it to become unstable over time. It could also be that it does not affect any of the other screws and is below the level of my instability so it doesn’t cause any issues. Time will tell on that.

I go back to the neurosurgeon the beginning of November and we will do more x-rays then to determine if there is any change. Right now we don’t really have a plan. My neurosurgeon is working with other surgeons to come up with a just in case plan b. Right now I am still in my cervical collar 24/7. I have been in it for an entire year next week (9/17) and will be in it for the foreseeable future.

Other than that my symptoms have been really good! I have had a great return of sensation to my right side, which is exactly what we were hoping for! I have been having a lot of pain from the hardware on the back of my skull. Anytime I lean my head against a head rest or a pillow I get a terrible headache on the back of my head. My surgeon is hopeful that this will go away with time, but right now it is quite bothersome.

There was another fairly major complication with my surgery, but I will save that for another post.

Please pray that we don’t need to do any more interventions and that my symptoms start decreasing.