Spine Cervical


Can you help me understand a neck injury my husband got from a horseback riding accident? The surgeon says it's a moderately severe fracture of C34 and surgery is needed. They won't be able to tell until they do surgery how unstable it is. What makes a fracture moderately severe and/or unstable? I didn't really want to ask too many questions in front of my husband in case it's worse than we thought.

Your desire to protect your husband, the patient is very admirable. Given the stress of the accident and preparation for the upcoming surgery, a low key approach is often needed for the involved individual. But questions like this are appropriate and the information important to family members trying to plan ahead.

My 16-year-old son has a cervical spine fracture rated as a three on a score called the CSISS. Can you explain this to me? The surgeon showed us the X-rays and went over everything. I am a nurse, so I do understand anatomy but I'll admit I was in a state of shock at the time. Most of it went right by me.

The Cervical Spine Injury Severity Score (CSISS) is one of several different ways to classify the severity of cervical spine injuries in order to predict who might need surgery to stabilize the spine. The CSISS is favored by some surgeons because it's easy to use by the surgeon and proven to be reliable and valid (accurate in predicting who needs surgery). The CSISS is for patients with neck injuries involving the lower cervical spine (C3 to C7).

New Classification System Takes the Guesswork Out of Treatment Planning For Neck Injuries

There's a move on now in the medical community to find reliable, valid ways to classify a problem and then decide how to treat it. In this study, orthopedic surgeons from St. Louis University School of Medicine check out the Cervical Spine Injury Severity Score (CSISS) for its user friendliness and accuracy. The CSISS is for patients with neck injuries involving the lower cervical spine (C3 to C7). This is an area of common injury.

What does off-label use mean? My surgeon was telling me about using bone substitute for my spinal fusion and had me sign a paper saying I know it is an off-label use. At the time I thought I understood it, but when I tried to explain it to my brother, I got all fouled up.

Off-label use means the drug, implant, procedure, or device is not being used for what it was originally intended or tested for. The practice is not illegal -- doctors who discover a drug that works well for one application may see many other potential uses. But without proper testing for safety, the Food and Drug Administration cannot approve that drug for a secondary or off-label use.

I'm going to have a neck fusion next month. I have a few weeks to mull over how I want to have the graft done. I can use bone from a bone bank, bone from my hip, or some new product that is a bone substitute. What do most people do?

Spinal fusion surgery has become a standard procedure for degenerative spine conditions that leave the cervical (neck) or lumbar (low back) area painful and unstable. There are many different ways to fuse the spine -- not only in types of materials available, but also approaches (from the front, side, back, or combination of directions) and techniques (with bone grafts, bone substitute, titanium cages, metal plates, screws).

Off-Label Use of Bone Substitute Causes Serious Problems

Have you ever heard the expression What's good for the goose is good for the gander?

I have some pressure on my spinal cord from bone spurs and compressed discs in the neck area. I heard that if this doesn't get better, there could be permanent damage to my spinal cord. Is that true?

You may have a condition called cervical spondylotic myelopathy sometimes shortened to cervical myelopathy. Disc degeneration and vertebral compression reduce the normal height of the spine. This puts increased pressure on the discs and facet (spinal) joints, which can lead to the formation of bone spurs.

I've been told that the neck and arm pain I have is from a condition called cervical myelopathy. No one seems able to tell me if I'll get better or not. What happens to most people with this problem?

CSM is a degenerative condition that occurs with aging. Adults affected most often are 50 years old and older. The term myelopathy refers to any problem that affects the spinal cord. Cervical tells us the area affected is the cervical spine (neck region). Spondylotic or spondylosis describes a narrowing of the spinal canal where the spinal cord is located.

What Happens to People with Cervical Myelopathy?

The natural history of cervical spondylotic myelopathy (CSM) is the topic of this article. Natural history refers to what happens to a person with this type of problem as time goes by. Do they get better, worse, or stay the same?

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