Rheumatoid arthritis often causes loosing of the tendons and ligaments.  My
friend needed a C1-C2 fusion (yep, that's right C1-C2).  They went around
posteriorly and cut her along almost the entire cervical spine.  They tried
using cadaver bone the first time(at the local hospital), second they used
hip bone.  If her vertebrae would have slipped she would have been a C1
quad.  They were very impressed with the professionalism of the staff and
doctors at Shands(Shands is affiliated with University of Florida Medical
Center/College, etc.) I would start by getting an official name for the
specific procedure and check out Medscape (www.medscape.com) they have
access to different articles.  You could also call/contact Shand's
www.shands.org
Neurosurgical Specialties (Adult & Pediatric)
Shands at UF/Health Science Center, Dental Wing, 2nd Floor, Room D2-43A
 University Neurosurgeons
720 S.W. Second Ave. Suite 458 Neurosurgical Specialties (Adult & Pediatric)
Shands at UF/Health Science Center, Dental Wing, 2nd Floor, Room D2-43A
 University Neurosurgeons
720 S.W. Second Ave. Suite 458 To schedule an appointment at any of these
practices, call
1-800 PHYSCIAN (1-800-633-2122) or 352-265-8000.

That should get you started, if they can't help you they may be able to hook
you up with someone closer to home.  I would say that spastisity and
anterior presentation would complicate matters.

Necks aren't my specialty but, they are attached to the rest and I know
enough to be dangerous.

Hope that helps get you started.

Beth the OT <gentle hugs>


> -----Original Message-----
> From: St. John's University Cerebral Palsy List
> [mailto:[log in to unmask]]On Behalf Of I. S. Margolis
> Sent: Wednesday, November 08, 2000 8:52 AM
> To: [log in to unmask]
> Subject: Re: A Pain in the Neck
>
>
> Thanks Beth,
>
> You're a darling.
>
> I'm wondering how does one find the "right" neurosurgeon?  One I went to
> in Maine prescribed a far more drastic procedure
> than the one in Philly.  Of course, I haven't been shopping a list of
> "right ones" either.  Don't even have a list.
> Rheumatoid arthritis isn't CP, so I don't see where your friend would
> have the post-operative difficulties
> anticipated for me.  What kind of surgery did your friend have?
>
> As implied, I've an anterior cervical stenosis. The docs would have to
> cut through the front of my neck to get to the back.
> They say they have to cut through good muscle, avoid arteries,
> anticipate much bleeding and infection.  Then they need to
> remove anterior cervical bone, replace with hip bone, fuse it.  They
> don't think they can remove the neck bone without doing
> damage to the spinal cord.  They're also not sure they can adequately
> immobilize me so I don't rip everything apart before
> properly healed.
>
> I may need lessons in positive thinking techniques.  My mathematical
> mind mumbles "High risk."  My usual courage takes on
> yellow hue.
>
> I'd appreciate more specific encouragement and information.
>
> Hugs,
>
> Steve
>
> Date:         Wed, 8 Nov 2000 06:50:09 -0600
> From:         "Elizabeth H. Thiers" <[log in to unmask]>
>
> Subject:      Re: A Pain in the Neck
>
>
> Steve,
>
> I have a friend of mine here who has rheumatoid arthritis.  Very severe.
> She ended up doing the surgery twice (the first bone graft didn't take
> as
> her hyperactive immune system rejected it).  She did finally go to
> Shands
> and have it done using her own bone and is has done the trick.  She was
> in
> and out in only 2-3 days.  The trick is to find a good neurosurgeon who
> is
> willing to work with you.  Recouperation was the hard part though as she
> needed to be in a neck splint for several weeks and needed extra help
> with
> self-care.
>
>
> Beth the OT
>
> > -----Original Message-----
> > From: St. John's University Cerebral Palsy List
> > [mailto:[log in to unmask]]On Behalf Of I. S. Margolis
> > Sent: Wednesday, November 08, 2000 12:56 AM
> > To: [log in to unmask]
> > Subject: Re: A Pain in the Neck
> >
> >
> > For me the damage to my arms, legs, and spinal cord has already been
> > done.  I'm trying to recover something of what I lost physically.  I
> am
> > seeing several doctors.  I also face life threatening neurosurgery to
> > remove, replace, and fuse anterior cervical bone pressing nearly onto
> my
> > spinal cord.  The docs aren't very optimistic about the results.
> >
> >
> > Steve M.
> >
> >
> >
>