Wednesday, October 17, 2007

Check this out!

This is a 3D CT scan done in NY last January (07) of my skull and neck. Obviously, this is a view of the back of my head and neck. This is what can happen when a Jefferson fracture occurs and the neck is rendered severely unstable.
I was told in NY last January that my skull has rotated backwards, coming to rest on the posterior of my C1.
You can see that here. The C1 is the horizontal bone just under the back of the skull (sub-occiput). It is longer across than all the other vertebrae, in effect it is a washer between the spine and the skull. Mine, as seen here, is tilting downward to the left, when it should be perfectly horizontal.
As you can see, this crossways bone (posterior of C1) comes to a point in the middle, on the top. In this picture of my spine, this point is seen right up under the base of my skull. My respected NY surgeon told me that there should be the width of my pinky finger between the bone and the skull. Thus, it's easy to see that the C1 is digging into the skull, and keep in mind that this was taken with me lying flat in an MRI machine, trying to keep my chin DOWN.

I had previously noticed that my MRIs did not look like others I'd seen, that my nose and chin were more pointing upward than I was seeing in imaging elsewhere (friends' and online). My surgeon told me, before I mentioned I had noticed this, this fact that my skull has rotated backwards.

He said it has also rotated to the left. This can be seen here, where my shoulders were square against the pad of the MRI I was lying upon, my neck is veering off to the left. Follow the center line of all the vertebrae, starting at the bottom. The spine goes up sort of to the right, then veers to the left, all sort of mangled, finally trying to come back to the center. This is what happens when a horse launches you and you land like a lawn dart upon your head! And, of course, the evolution over time of instability is a big factor.
This shows so well why I need the craniocervical fusion, including the extraction upwards pre-fusion. Rods will be placed down almost the entire back of my skull, held in place by screws. The rods will then go down my Cspine to C4 or 5. The CT of Keesha's fusion illustrates what this will look like.
When I tilt my head upwards at all, it's easy to see how much worse the compression between the C1 and skull/occiput is, considering this is how it looks when I'm lying flat and trying to keep my chin down.
Also to keep in mind (for those who are medically-curious): this shows what is happening on the outside. What about the inside? What bones are in the wrong place and compressing nerves and tissue, including brainstem?
The craniocervical junction harbors all the cranial nerves, which are twelve pairs of nerves that emanate from the nervous tissue of the brain.
I post this here so others can learn and for those with Jefferson Fractures in order to see more clearly what can happen. Too often such people are told they will be fine, as was I. I was not fine, and it took 3 years to find a surgeon who truly understood. One of the tools in his arsenal is the 3D CT scan. Isn't it incredible?
By His Grace, I am alive.

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