A smaller group of our readers had surgery for their curve. For some it was decades ago, as teenagers; for others it was recent, as adults. Either way, part of the spine is now fused and held by hardware, and it has been quietly doing its job. Then a car crash happens. This dispatch is about who needs to hear about it, and what to tell them.
It is not about what the crash did to your fusion. Nobody can answer that from a webpage, and this desk will not try.
First: the bright line
Everyone goes by the same emergency line, with or without hardware: chest pain, a sudden severe headache, weakness or numbness on one side, trouble speaking, a loss of bowel or bladder control, or a head injury with vomiting or worsening confusion goes to the emergency room now. So does new numbness, tingling or weakness in the legs after a crash, and back pain that is severe and getting worse. If you are taken to an emergency department, tell them about the fusion before anything else: the approximate levels, and the year.
The call people forget: the surgeon's office
If the crash did not send you to an emergency room, the next call is the office of the surgeon who did your fusion, or the spine practice that follows you now. Many people skip this call because the surgery was long ago, the surgeon has retired, or the crash seemed minor. Make it anyway.
What to say is short:
- "I had a spinal fusion for scoliosis in this year, with this surgeon, if you have the name."
- "I was in a car crash on this date. Here is what happened, and here is what I feel now."
- "Do you want to see me or order any imaging, and is there anything I should or should not do in the meantime?"
Whether you need to be seen by the surgical practice is their decision. Write down exactly what they tell you, with the date. If your original surgeon is no longer practicing, ask the practice or the hospital who now sees their former patients. If you have moved to the St. Louis area since the surgery, a spine practice here can take that call.
What to tell the injury examiner
A fusion changes what an examiner needs to know before they begin. Give them:
- The levels fused, as best you know them. "From the upper back to the waist" is a real answer if you do not know the numbers.
- The year of surgery, and whether there were any later operations.
- What the surgeon's office said after the crash, including if they have not called back yet.
- What your spine was like before the crash: how the areas above and below the fusion usually feel, and any ache you have lived with for years.
- What is different now, and exactly where. Clinicians often pay particular attention to the parts of the spine just above and just below a fusion, so be specific about location.
Bring the operative report or your most recent films if you have them. Finding your old films covers how to track them down, and the exam does not have to wait for them.
Ask what the clinic will and will not do
You are allowed to ask plainly, before anything is done: what do you plan to do, and how does my fusion change that? A clinician who examines you can tell you what they will do, what they will not do around fused levels, and when they would rather send you back to your surgeon or for imaging. An office that says "that belongs with your surgeon" is doing its job. Tell the surgeon's office what the clinic plans, too, so neither is working blind.
The parts that did not get fused
A fusion holds part of the spine still. The neck, and whatever parts of the back were not fused, still move, and they still take the load of a crash. The rapid back-and-forth neck motion that the National Institute of Neurological Disorders and Stroke describes on its whiplash page happens to people with fusions too, and that strain often shows up on a delay; the slow week describes the first days. Do not assume that because the middle of your back is fused, the crash had nowhere to go.
Keep a short log
For the first two weeks, write one dated line each day: where it hurts, anything new, any numbness or tingling, how you slept. The record explains why dated lines matter for a spine with history. New or spreading numbness or weakness is not a log entry, though. It is a call today, and if it is in the legs or comes with bladder or bowel changes, it is the emergency room.
Where the exam happens
Missouri Injury Clinic, run by Joseph L. Hollingsworth, DC, takes auto-injury patients at three offices. O'Fallon, 2163 West Terra Lane, (636) 280-0990, is nearest for most readers west of the rivers, open Monday, Tuesday and Thursday 9 to 6 with Wednesday and Friday by appointment. Hazelwood, (314) 627-1411, and Tesson Ferry, (314) 530-5480, cover north and south county, Monday through Thursday 9 to 6 and Friday 9 to noon. Every office closes from 12 to 2. When you call, say auto injury, scoliosis and fusion, in that order.
Your fusion was a long-view decision. The week after a crash is not. Make the calls this week, and let the people who can examine you sort out the rest.
The bright line. Chest pain, a sudden severe headache, weakness or numbness on one side, trouble speaking, a loss of bowel or bladder control, or a head injury with vomiting or worsening confusion is an emergency room trip right now, not a call to a clinic.