OK guys, here is the SITREP that so many have been asking about.
After multiple delays, I finally got into the Neurosurgeon’s office as the last patient yesterday (22 Apr 15)
To facilitate understanding (and to record my memory for possible future reference) I need to get a tiny bit technical.
In general, there are three major phases of fracture healing. Two of them are further subdivided to make a total of five phases:
1. Reactive Phase
a. Fracture and Inflammatory Phase
b. Granulation tissue formation
2. Reparative Phase
a. Cartilage Callus formation
b. Lamellar bone deposition
3. Remodeling to the original bone contour
The good news is, after 19 weeks, there is some sign of healing. The bad news is that progress is only to phase 2.a. Cartilage Callus formation. The Dr. referred to it as a “fibrous substance.”
And the CT reveals that the break in the vertebra is indeed welded shut—only problem is that the fibrous substance is not bone (and not as strong).
Further good news (to me anyway) is that surgery is out of the question. There are two approaches—anterior entry and posterior entry.
The problem with the anterior entry approach is that there is so much osteo “debris” (left over junk from silly stunts pulled during my miss-spent youth) that it would be virtually impossible to properly position the screw.
The posterior approach is simply too risky—according to the Dr. the benefits do not measure up to the risk. In other words the cost: benefit ratio is less than 1 in his opinion—and that suits me fine. It is unnerving to even think of having a knife stuck in your neck.
So, where does that leave us? Another 6 weeks in this damned “horse” collar. Of course, we are looking for some bone to show up.
Hope springs eternal. But, the bad news is that, in the Dr.’s words, “It may never heal properly.” I responded, “I would have to be very careful.” He answered, “You would have to be very careful.”
So what now? I go back in 6 weeks for another CT scan. If it is totally healed, Ou Rah! I’ll fall down in floor of the Dr’s office and do a wrestler’s bridge (just joking).
If it is developing bone but not totally healed yet, probably another 6 weeks in the “horse” collar.
If it is not developing (i.e. there is no change between now and then), we will just discard the “horse” collar and let Mother Nature take her course—very carefully.
That’s it as I understand it and thank you all for your support and encouragement.
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