Week 3 - Mia Huang

 I can't believe it has been half way through the immersion term. I had a great independence day weekend and saw the Van Gogh Immersive exhibit at pier 36, visited MoMA and watched fireworks over the east river.

On Wednesday, I saw a posterior cervical fusion C6-T1, laminectomy at C1, and foraminotomy C1-2. On Thursday, shadowed Dr. Riew on his clinic day. I learned that after a cervical fusion surgery, 40% people won't heal without the application of the bone morphogenetic protein (BMP). However, only 5% of people won't heal when the BMP is used. In patients with osteoporosis, the screws used to hold the plates for cervical fusion don't stay as well leading to weak fixation, but the bone still heals the same way as in non-osteoporotic patients. Patients with osteoporosis have to be even more careful with the collar and not to move their necks within the first 6 weeks after the surgery. In patients with osteopetrosis, their bone is very hard, making the screw fixation rather secure in a cervical spine fusion surgery. Those patients tend to have better and easier recovery and healing. For patients who experience neurological deficits due to spinal cord myelopathy, when they experience loss of balance and tripping under 4 month, they have a better chance of reversing the symptoms after the surgery. However, if the loss of balance and tripping symptoms go on for more than 4 month without treatment, the symptoms are more difficult to reverse and could persist even after the surgery. It is very essential for patients to seek medical care immediately when they experience neurological deficits.

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