Medical Notes for Susana’s Car Accident

Posted on March 28, 2009
Filed Under Personal |

The following is a summary of the medical status of Susana as of 29th March 2009. She has yet to decide on her action path and is waiting upon results in order to make a more informed decision. Please READ the following notes before asking Susana “what’s happening” as it will save her breath and a lot of time trying to repeat the same information to everyone that asks.

A MAJOR thanks to Frances to putting this together for all of us. I take no credit in the development of the material below!

Basic Anatomy

1. In your neck there are 7 (cervical) vertebra or bones that are connected into a long tube with a hollow centre. The spinal cord runs through the middle of this hollow tube and is protected by the bodies of the vertebra.
2. Spinal discs are spongy ‘pillows’ that separate one vertebra from another. They give flexibility to your spinal cord as bones obviously don’t bend, but kind of like a slinky, having the discs between each vertebra gives your neck it’s flexibility to bend forwards, backwards and side to side. Rotation of the head happens at the top two vertebra (C1 and C2)
3. Ligaments are connective tissue wrapped in strategic areas vertically along the spine (front, back and along the sides) to stabilise the entire spinal structure.

Susie Q:
Has fractured her C5 vertebra at three spots, along the front and two places across the back.

This means she isn’t allowed to move her neck because the structure protecting her spinal cord at that level is no longer completely whole and working

At the moment the fracture hasn’t actually seemed to have damaged the spinal cord although the cord itself is a little bit swollen (bruised) which is why she feels a little weak in her arms and legs.

The other thing is that even though the bone bits (in the vertebra) haven’t moved as yet, the ligaments might have been damaged so the spine isn’t completely stable.

Options for treatment

Option 1: No surgery (+/- yet)
Bones heal everywhere in the body but they take time. Susie-Q can wait 6 weeks or so for the bones to heal but in that time she will have to lie completely still because moving can aggravate the healing process.

After that, the doctors can scan the neck again and check whether there is healing of the vertebra

But if the ligaments are damaged (which the doctors already suspect), then there isn’t any stability in the neck structure. Even if the bones heal, ligaments can stay ‘stretched’ for a lot longer or permanently and Susie Q might never have stability in that area so might still go on to have surgery.

But she could delay/omit having a major surgery.

Option 2: Surgery
The surgeons can remove the major fractured area(s) and graft bone from her pelvis to the neck. That is, rather than waiting for bone in her neck to heal; take more ‘active’ bone from her hips and move it to her neck. In the long term, this bone should graft continuously with the vertebral body and become as strong as the original.

But whilst waiting for the graft to take and remodel, the surgeons would stabilise the neck with a metal plate and rod screws into C4 and C6 (undamaged bones above and below the fractured C5). These would stay in there permanently and take the job of the ligaments in that area.

To do this they would remove the spongy discs between C4/C5 and C5/C6 so the bones are all sitting on top of one another. This results in some limitation of movement of the neck and a risk of earlier arthritis (bone rubbing on bone) but that all depends on the person.

The risks of surgery are there but specifically include damage to the spinal cord and failure of the surgery (requiring more surgery).

Popularity: 6% [?]

Comments