Ross Hauser, MD
Recently, medical research warned that as surgeons began to increase their recommendations to cervical surgery, the number of failed procedures and the number of cervical neck surgeries would increase with it. 1
This is why we see many patients who had a cervical spinal fusion include symptoms reflective of cervical adjacent segment pathology (CASP). This means that they are having pain from the cervical spine, above and below the original fusion. Some have recommended to them a revision surgery that includes more include fusion, laminoplasty and disc arthroplasty.
In a recent study, surgeons question whether the muscle attachments at C2 and C7 are important to keep in Laminoplasty, many think they reduce post-surgical pain, others think there is not enough evidence to “spare” the muscle attachments. 2
Neck Fusion Surgery Complications
Sometimes the problems of a failed cervical surgery can be fixed with a bigger screw and some paste to hold it to the bone. This occurs when the plate and cage used to hold the fusion together loosens. How many more bigger screws will the patient need is hard to tell, but eventually there will not be enough bone to hold an ever increasingly sized screw?
Cervical surgery is a complicated surgery and should always be the absolute last resort for the patient. Revision surgery as noted above is even moreso complicated with much higher risks.
Prolotherapy for Neck fusion surgery complications
In our published , we followed 98 patients undergoing dextrose Prolotherapy treatment for unresolved neck pain. These patients
Reported neck pain of average for 59 months. They had seen an average of more than three physicians prior to being treated quarterly with Prolotherapy.
On average 18 months following their last Prolotherapy session, patients were contacted and asked numerous questions in regard to their levels of pain and a variety of physical and psychological symptoms, as well as activities of daily living, before and after their last Prolotherapy treatment. The results of this study showed that patients had a statistically significant decline in their level of pain, stiffness and crunching sensation with Prolotherapy.This included patients who were told by their doctors that there were no other treatment options or that surgery was their only answer for their chronic pain.More than 83% of patients showed improvements in walking ability, exercise ability, anxiety, depression and overall disability with Prolotherapy. Ninety percent of patients who were on pain medications at the start of Prolotherapy were able to cut their medication usage by 50% or more. Additional pain management care was able to be lessened by 50% or more in 75% of cases with Prolotherapy. Ninety-eight percent of patients stated their pain was better with Prolotherapy. Ninety-seven percent of patients said Prolotherapy changed their life for the better. 3
The key to avoiding cervical spine surgery, is preventing the surgery with conservative treatments. In our opinion Comprehensive Prolotherapy including the use of Platelet Rich Plasma Therapy, Stem Cell Therapy, and Dextrose Prolotherapy with and without other growth factors offers a realistic chance to avoid surgery be strengthening the supportive ligaments and tendons of the cervical spine region, stabilizing the area and preventing further deterioration.
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1. Helgeson MD, Albert TJ. Surgery for Failed Cervical Spine Reconstruction. Spine (Phila Pa 1976). 2011 Nov 8. [Epub ahead of print]
2. Riew KD, Raich AL, Dettori JR, Heller JG. Neck Pain Following Cervical Laminoplasty: Does Preservation of the C2 Muscle Attachments and/or C7 Matter? Evid Based Spine Care J. 2013 Apr;4(1):42-53.
2 . Hauser R, Hauser M. Dextrose Prolotherapy for Unresolved Neck Pain, Practical Pain Management, October 2007