I had a patient a few years ago that only came in on an occasional basis, usually when she was hurting.  I hadn't seen her for several months when she came in with a very serious complaint.

Not only did she have neck and upper back pain, she had radiating pain in the arm and hand.   She also had muscle weakness and loss of reflexes in the left arm.  These are signs that something was interfering with nerve transmission into the arm.

Tipping the head to the left increased the pain in the neck and arm, and tipping it to the right decreased the arm pain.  This showed that the problem was related to the point at which the nerves exit the spine in the neck and then move into the arm.

We took x-rays, and the side view of the neck showed a complete reversal of the natural curvature of the neck, focused right at the disc between the 5th and 6th cervical vertebrae (spinal bones in the neck).  The nerve root that leaves the spine from this level correlated with the muscle weakness and loss of reflexes in the left arm.

We started care with this patient right away, but at the same time, I also sent her to get an MRI.  Not because I needed it.  I already knew what the problem was and I knew what I was going to do to try to help her.  I sent her for the MRI just in case we weren't successful.  If I couldn't help her, I wanted to have already started the process necessary to be able to send her along to a surgeon with very little delay.

I shouldn't have worried.  She responded very well to our care.  It was only a short time before the left arm was back to normal and she was feeling much better.  

Unfortunately, getting the MRI had led to a consultation with a surgeon, and he recommended surgical fusion.  Her parents, who were very concerned about her, had no previous experience with chiropractic and declined her requests to speak with me about our plans for her care. 

They pressed their daughter to go ahead with the surgical fusion, despite the fact that her symptoms were almost fully resolved there was a good chance we could correct the curve reversal in her neck without surgery.

She relented, and the surgery was scheduled.  It was to be an "anterior single level fusion with instrumentation."  They were going to go in from the front of the neck, cut out the disc at the C5-C6 level, insert a bone fragment, put a metal plate over the front of the two vertebrae and attach it with two screws in each vertebra.

The x-ray below was taken when she came back after the surgery to tell me what had happened.  She was very upset.

When you look at this picture, you'll see that they did a lot more than the procedure I described above.  I never spoke to the surgeon, but I can see from the x-ray what must have happened.

The complete procedure was intended to consist only of the metal plate and four screws at the front of the spine (left side on the x-ray).  They first removed the disc and inserted the bone fragment.  So far so good.  Then they put the plate over the vertebrae and screwed in the lower two screws.  Everything still going according to plan.  Now they drill in the upper two screws.  But this doesn't go well.  It appears that the plate is too short.  The screws are too low and project out the bottom of the vertebral body.. notice that they're just right above the bone fragment they had just placed.  The result?  The screws stripped out!

Now what do you do?  Not much choice.  You can't leave her like this.  You just took the disc out and put in a piece of bone, but there's nothing to keep it there and the plate won't stay put because the screws are stripped out.  Her spine is unstable.  She could be paralyzed if she turns her head sharply!  No choice but to stabilize it some other way.  So they turned her over and did a three level instrumented fusion from the other side.. 

So what happens to this girl now?  When she came to see me after the surgery, she told me that she is already rated as being 100% disabled.  That's not the worst of it.  If you look at the spinal disc immediately above the fused segments, you can see that it is already showing some evidence of stress, with the vertebra above being displaced forward.  The load from the three discs that are no longer functional will now be picked up by this disc.  How long do you think it will last?

The above patient rolled a GMC Safari van, almost tearing the spine in two.  She was referred for surgery, but chose not to do that.  Ten years later, she never has undergone surgery.

This fellow was in a lot of pain when we started.  It took us a couple weeks to get the pain knocked out.  We continued on and were able to achieve a good postural correction.

If you look carefully at the lower part of the neck in these films, you can see the beginnings of arthritic change resulting from the reversal of curvature.  That's why we were able to achieve a better correction up above than below.. we were limited by the "scarring" in the lower area.

I know there are times when surgery is necessary.  To me, that's when there is a significant crisis that can't be addressed any other way.   Surgery is required to either save their life or resolve the crisis. 

This patient in this story wasn't in crisis.  She was showing steady improvement under conservative care.  This was a surgery that never should have been performed.  And this is a life that will be permanently and significantly altered.. unnecessarily.