Spinal fusion is an attempt to stabilize the vertabrae which maybe causing
nerve-impingement. Its not always successful as you can imagine, something
as complex as the spine, has to be in the *exact* right position before
fusion, otherwise the outcome can be less than satisfactory. Having said
that, these days with the wonderful imaging technology available, failed
surgery is more remote. I feel sure the Drs would have explored your
S-daughter;s condition thoroughly before coming to this conclusion
(surgery). In patients who have lessor neck conditions, neck-traction can
work wonders. I assume she has been under a physio at some stage or tried a
neck-brace? If the neck injury was the result of an accident tho, it may
well be there is damage which is just beyond non-intervention help.
In the US, operations are posible for the poor at no cost I understand at
some mercy hospitals? Perhaps there is a hospital which is prepared to take
her on, on a no cost basis.

regards,..Jason

If you don't mind answering, more information here will help. Is your SD a
parent? Traditional Medicaid will not help her out if she has no dependents.
BTDT. Many states have catastrophic medical assistance, which will provide
coverage after she spends a certain amount. Medicaid also limits your choice
of doctors. Why is she unemployed? Where does she live, how does she pay for
her living expenses? If she is not working due to her condition being
disabling, she could try for disability, which would then provide her with
medical coverage.

I have Occipital Neuralgia, which developed following an auto accident. I
had a consult with a neurosurgeon who recommended I *not* have surgery. My
SIS had surgery on her neck (a fusion), and it has essentially failed. Has
she tried PT? What medications does she take, if any? I use generic fentanyl
(Duragesic is the brand) patches, and Lidoderm, both are expensive.
Lifestyle changes and meds were what was recommended to me, I've learned to
live with it. Right now I'm having problems, I suspect the Occipital nerve
is inflamed, as I have been having head and shoulder pain.

Dear KW,

Your evaluation of the physicians involved is a clear indication of your
next step. Get her away from those doctors. Perhaps you will find this study
in your searches, it was a fairly recent one done over a couple year period
but the results were out within the last 2 years that fusion and Physical
Therapy end up having the exact same success rate. Surgery is a crapshoot
almost always. Fusing the vertebra always put more load on the level above
and level below, usually resulting in multiple fusions. Not a good long term
prospective for a young girl, or anyone of any age, but she's got a lot
longer way left to go depending on this outcome than most to of us do.
If the situation is stable for now and there's no risk of a bone fragment
cutting in to something vital, I'd be more interested in the diagnosis as
opposed to what the ambulance chasers are calling for as resolution. Is
there fragmented bone? A bulging or damaged disk? Why the cutting is
necessary, more so than their intent.
An MRI report should be written in enough semi layman to sitdown with a
dictionary (medical or otherwise- a medical one may be more complex than
needed) and pick through the diagnosis to arrive at something more
understandable. There's also a test called an EMG that is essentially a
nerve conduction study. It involves needles and electronic current but
should give you an idea of the nerve being affected. That should open up the
options for alternatives to fusion or surgery all together, the whole idea
being avoiding the knife and if not an option avoiding fusion.
There's a relatively new procedure where the actually replace the disk with
an artificial one, maintaining flexibility rather than hindering it by
immobilizing the joint. We have very few people that have come through here
having had it done. Being a chronic pain group that can mean a lot of
things. It could be very successful and not leaving many in pain so they
don't have need for this kind of support group. It could be terrible and
kill people before they get a chance to get on the net to complain about it.
Or maybe there just aren't many having it done. Fusing is definitely the
more popular of the procedures and they do lots of it, but is it the better
alternative? As many succeed as fail (we get the majority that fail in here,
but such is the nature of our group) Docs tend to stick with what they know
best as a solution, that doesn't make it the best automatically, just the
default procedure.
I would tend to doubt the word of any doctor that says it's an emergency at
the moment, simply for the fact they went for physical therapy first. If the
circumstances were dire, her first stop would have been the Operating room
and this thread would be moot (love that word-moot).
I'd like to hear more of the MRI report and the EMG if one was performed. It
should be a page or two max on the MRI report and the EMG should only be a
line or two. That will help a lot in advising you. And please remember as
someone else mentioned we're not medical professionals. Professional
patients maybe, but that doesn't qualify us to make the big(or little)
decisions.
One thing I would suggest or advise is that for the most part, pain control
will not affect test results, so there's no reason for lack of pain control.
Addiction is a bug-a-boo and a poor excuse for keeping a young girl in pain.
Age could be, depending on the choice of medication. Be wary of
acetaminophen containing drugs. Even the Tylenol guys, probably the best
known and sold variety of the drug, caution use for more than 10 days in a
row. I'll stop right there as I usually write books (not that this is a
short post by any means), on the dangers of that class of medications. 4000
milligrams is the dose ceiling per day and it sounds like alot, but it can
easily accumulate to that much when there are many drugs being taken and an
occasional  couple of extra strength Tylenol popped in for headache or
something here or there.
The more diagnostic info you can toss our way the easier it would be for you
and us to search out alternatives to the knife. Type of docs is helpful too.
She should have seen at least one orthopedic and one neurological doc for a
consult.

Give her our best wishes for a painless day--og