Question:My brother was in a diving accident while on his honeymoon in Hawaii. He dove from a 65-foot cliff and broke his neck in two places. Right now he has titanium screws and plates to hold everything all together. How well does this work?
Answer:Over the years, surgeons have tried many different methods of stabilizing a broken neck. The danger of damage to the spinal cord makes this kind of injury difficult to treat.
Hooks, wires, screws, plates, rods, and combinations of one or more of these devices have been used to hold the bones together. Fixation can be used to stabilize the neck while waiting for healing to occur.
Instrumentation of this kind has its own problems. It can pull out or migrate (move). It can also break. There's always the risk of damage to the nerve tissue as the hardware is installed in place.
Results of fusion with screws have been good. Improvements in the hardware, better screws, and imaging during the procedure have all contributed to an improved outcome.
Newer techniques and updated materials like the translaminar screw will continue to improve this operative technique. Diving and contact sports are no longer allowed for your brother. With the right kind of rehab program and regular activity, your brother should have a very positive result.Ryan M. Kretzer, MD, et al. Translaminar Screw Fixation in the Upper Thoracic Spine. In Journal of Neurosurgery: Spine. December 2006. Vol. 5. No. 6. Pp. 527-533.
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