Houston Methodist. Leading Medicine

Neck FAQ

Question:

I have a severely degenerated cervical spine mostly at C2 but a little bit of C1. I've been wearing a halo vest until the surgeon can schedule me. I haven't even had a preliminary appointment yet. What kind of procedure can they do for something like this?

Answer:

Instability of the cervical spine (neck) severe enough to require surgical fixation occurs as a result of trauma, congenital malformations, or bony destruction from diseases such as cancer, arthritis, and infections. As in your case, the upper cervical bones degenerate to the point of collapsing from underneath the skull. Without support of some kind, the risk of pressure on the spinal cord is too great to leave the problem untreated. External "fixation" such as collars and halo vests are temporary until surgery can be done. Internal fixation is the next step. Fixation means the surgeon is literally using metal plates, screws of various types, and rods to hold the base of the skull attached to the back of the cervical vertebrae. Modern rod-and-screw fixation techniques have replaced the earlier wire and bone graft methods of fixation. Bone grafts are still used to augment fixation devices such as preshaped rods and contoured plates. Different types of locking screws are used and placed in different positions or parts of the spinal bones. These devices can be angled to meet each patient's needs. Specific motions (side bending or rotating the head) can be prevented according to the patient's pattern of instability. Once the surgeon has a chance to evaluate your particular situation, then a plan of care can be developed. You will likely be shown X-rays, MRIs, and schematic drawings of the proposed procedure. Be sure and ask any questions you may have in order to fully understand what is being proposed and what you can do to get the best result. Richard J. Bransford, MD, et al. Posterior Fixation of the Upper Cervical Spine: Contemporary Techniques. In Journal of the American Academy of Orthopaedic Surgeons. February 2011. Vol. 19. No.1. Pp. 49-58.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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