C2 no longer healing

Tagged: C2, NECK fracture, vertebrae

Viewing 6 posts - 1 through 6 (of 6 total)

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dustin330
Participant

June 19, 2018 at 7:33 pm

Post count: 2

#28554

I fractured my c2 in a motorcycle accident about 6 weeks ago. My fracture wasn’t severe enough where they had to do surgery right away. I chose to go with the Halo brace 2 days after the accident. I’ve been in this halo brace for the past 6 weeks. The surgeon initially told me I would be in the brace 6-8 weeks.

I’ve been seeing the same ortho surgeon that treated me in the hospital. 2 weeks ago they did X-rays and it showed that the vertebrae was starting to heal, I would say it looked 75% healed. He was excited to see this healing, as was I. Today I went there to check in with him and get more X-rays, he said that if it looked healed enough the halo would come off. Now the X-rays today looked like that healing was almost all gone. You could clearly see the fracture and all solid white in the X-ray was no longer there. I was very confused how this could be and he could not really answer how it could happen. I’m going for a CT scan within the next few days so he can see for sure what is going on.

Does this sound familiar? Can a bone go from healing and fusing to not healing anymore? I was pretty upset today with this news as I am really looking forward to getting this halo off.

Donald Corenman, MD, DC
Moderator

June 22, 2018 at 5:16 pm

Post count: 8660

#28570

X-rays are notorious for poorly defining C2 fracture healing. The area of the fracture is very important for healing consideration. There are type I, II and III fractures of the dens and “hangman’s” type fractures. Type I is uncommon. Type Ii is very common and is fractured right through the dens of C2. This fracture takes months to heal and if displaced, will not heal well if at all. I will assume this was a type III fracture of the dens or a hangman’s fracture. These have much better healing potential in a halo but it should take about three months to heal these fractures. The CT scan is a necessary next step.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.

Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

dustin330
Participant

June 25, 2018 at 5:56 pm

Post count: 2

#28620

To clarify, I have a type II dens fracture 4mm.

I went to the doctor today, this would make 7 weeks with the halo-brace on. I had a CT scan done on Friday so I was here to see what he thought. He said just as he thought, the C2 is not healing as it should. I was told that by this point, 7 weeks with the halo, they should be able to see signs of fusing.

He recommended an anterior screw fixation surgery with 1-2 screws on the odontoid. He gave me the option of keeping the halo on for 4-6 weeks more, but I can only assume this would be a waste and I would be in the same situation at the end of that time. I asked another doctor that came in about Range of Motion and she said this surgery would not effect my ROM a lot. It would be a small measurable loss but not something that I would notice.

Donald Corenman, MD, DC
Moderator

June 26, 2018 at 6:27 am

Post count: 8660

#28623

I’m not sure if the 4mm means the fracture is displaced 4mm or the fracture line is 4mm from the tip of the odontoid. The angle of the fracture line, the opposition and displacement all affect the potential healing. If the fracture is not angulated posteriorly, the screw fixation is a good procedure.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.

Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

Andreas
Participant

August 19, 2021 at 6:04 pm

Post count: 1

#34297

Hello.
I had c1 c2 fracture possibly 3 months ago, and I was wearing schanz to heal, but now after 3 months, it cracked again, I guess, since I was accidently turned into bad sleep position, and when I woke up, I felt the cracking sound.
Now when I twist a little my neck, I feel that clicking feeling again.
If it is really broke again, is it still a good chance to heal by itself, if I am able to rest with it totally for another half year?
I can move my neck properly.

Donald Corenman, MD, DC
Moderator

August 20, 2021 at 1:32 pm

Post count: 8660

#34298

Fractures of C2 are normally of the dens, the bony peg-like process that C1 attached to but there are others that are quite different. If it was a dens fracture, healing depends upon your age, the displacement and angulation of the fracture. They can heal but healing takes a while and some don’t heal. You would need a spine specialist and a CT scan to determine your healing status and whether your neck is stable or at risk.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.

Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
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Donald Corenman, MD, DC

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Eric S

Sep 26, 2021

by Eric S on Donald Corenman, MD, DC

Successful pars repair at 46 years old

Back in November of 2018 (at 46 years old) I came from Vancouver BC to have a pars repair done with Dr. Donald Corenman at the Steadman Clinic in Vail Colorado. I'm finally posting this review nearly three years later in late 2021. The reason I waited so long was I wanted to know the final result before I posted my review. Unfortunately in that time Dr. Corenman has retired. Nevertheless, I want to post this review of Dr. Corenman and his staff at the Steadman Clinic in their excellent treatment of my L5 pars interarticularis.

I fractured my pars at age 42 back in 2014 when rolling on the gym floor, and was denied treatment by the Canadian healthcare system, probably due to my age. First my GP told me there was no surgical option for a pars defect, which was quite incorrect! I tried to live with it, but the symptoms worsened (periodic random spine slippage and weeks of resultant pain after just bending over to tie my shoe, so I eventually learned to mostly squat and hardly bend). When I finally consulted with Canadian spine surgeons, I was told they believed my pars defect had been congenital (since birth). This was absurd, considering I had done extreme martial arts (including jiu jitsu) for years prior, as well as 5 years of reinforcing steel full time in my 20s, probably the hardest job on the back you can find. No pars defect like mine would possibly have allowed this--ergo it was impossible that I had had the defect since birth. I did however have an asymptomatic congenital spina bifida occulta that made me more susceptible to a pars fracture. In 2014 in one instant, I went from having the strongest back people I knew said they'd ever seen, to being unable to safely bend over and tie my shoe without a non-negligible risk of my spine slipping randomly (which would lead to weeks of pain after each occurrence). This was due to the unilateral L5 pars defect, otherwise known as spondylolysis. It was when lying in pain on the floor 4 years later after maybe the 6th spine slippage event post injury, that I had had enough, and resolved to have surgery. If Canada's "universal health care" said no, I would make lemonade from lemons, and find the very best surgeon in the world at pars repairs. That was Dr. Donald Corenman. Dr. Corenman back in 2018 ran a website https://neckandback.com/ that dedicated many pages to the science of every aspect of pars repairs, from eligibility (good discs on MRI), to best surgical techniques (minimal open compared to minimally invasive), best imaging to use (i.e., O-Arm with Stealth imaging vs. older fluoroscopy), the ideal amount of BMP to use and why not use too much or too little, and much more, all to do with pars repairs, pages upon pages of his site just on the pars, with scientific references and his own extensive expert opinion. As a health research statistician, I was very impressed with this. It was in stark contrast to the websites of other spine surgeons which barely gave the pars a word or two, focusing almost exclusively on fusions. I had found the best surgeon in the world for pars repairs, and so after Dr. Corenman personally screened my MRI to ensure my discs were healthy, I booked the surgery.

Being 46 years old at the time of surgery in 2018, with a 4-year-old pars fracture from 2014 combined with a congenital SBO meant my pars fragment was somewhat atrophied, but it was "very solid", said Dr. Corenman in the operative report. Nevertheless, it was challenging with two things to fix, the pars and SBO, and OR time was around 4 hours. Recovery over the following months was guided by a very clear "Spine binder" from the Steadman Clinic with strict rules of "no BLT" (no bending, lifting or twisting), and illustrated physiotherapy guidelines. They even warned patients to avoid fish oil supplements, which could excessively dampen inflammation and hence slow bone healing. They answered many questions I had during months of recovery, with responses coming from the very supportive Lori Fugate (then director of Dr. Corenman's practice), and Ehrich Bean (then physician's assistant at the practice), as well as a couple calls with Dr. Corenman himself after two of the CT scans. Ehrich Bean offered great advice for taking the spine binder conservatively due to the nature of pars repairs vs. fusions. The final post-op CT scan I had was a couple weeks ago at 34 months post-op, and Dr. Corenman had retired, but I got a very positive and informative call from Eric Strauch (current PA at the Steadman Clinic under Dr. Corenman's replacement there, and who had also worked with Dr. Corenman previously). The staff at the Steadman Clinic were extremely supportive all the way through the process. I should mention, the local Canadian spine surgeon did offer me very good post-operative support including antibiotics as needed to deal with a mild surface incision-site infection early on, booking numerous x-rays when I felt something was amiss, as well as booking all four of my post-op CT scans. I am very grateful for that support also.

My final result shows plenty of solid bone across the pars and a healed SBO, with my vertebral body now a solid bone ring instead of being broken at two places as it was pre-op. Does my spine hold up in the real world? You bet! I have recently dug and moved several yards of dirt and sand and gravel by myself (shovel and wheelbarrow!) to fix our water main, pulled roots from the yard, moved several "portable" (these are HUGE) air conditioners up several flights of stairs my myself, and lifted weights. I now run 2 miles (3.2 KM) several times weekly with a hard 100 meter dash in the middle. I bend deeply before each run I go on, with no spine slippage. My spine feels amazing. I can bend over to do exercise, or real word tasks, with no risk of spine slippage.

My sincere thanks to God, Dr. Donald Corenman, Lori Fugate, Ehrich Bean, Eric Strauch, and the Steadman Clinic, as well as the Canadian spine surgeon who offered me excellent post-operative care back in Canada. You have all given me a new lease on life.

Sincerely,
Eric S

Robert S

May 11, 2021

by Robert S on Donald Corenman, MD, DC

Back Fusion Surgery

I had my entire lumbar spine fused in November of 2018. I had scoliosis , with pinched nerves that were so painful I could hardly walk - and standing for more than a few minutes was impossible. Even sitting was painful.
The fusion surgery produced immediate relief! And the recovery was much easier than I expected.
To this day I can do all the activities I love from hiking, to standing in a stream fly fishing to riding my bike long distances - or just walking down the street with my wife.
Kudos to Dr. Corenman and his staff, (including the two Erics) for taking such good care of me!

Leslie R

Jul 9, 2020

by Leslie R on Donald Corenman, MD, DC

TLIF

I had my TLIF surgery on 6/24/2020 by Dr. Corenman, I can not say enough good things about the Dr or his staff. I was always treated with respect and explained everything throughly, that made it easy for everyone to understand. I highly recommend Dr. Corenman and the Steadman Clinic.

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