C2 Vertebra Issues: Impacts on Arm Circulation and Treatment Options

Q: C2 Vertebra Issues: Impacts on Arm Circulation and Treatment Options

Hello： 1. <br>What you mentioned： "There is an old fracture at the second cervical vertebra, but it has healed; however, the ligaments may have become lax." Generally speaking, if there is ligament laxity at C2, the symptoms often include occipital pain. <br>Additionally, laxity

Cervical vertebra 2 (C2)

Hello Dr.
Lai, I previously raised a question regarding my right arm feeling poor blood circulation (#140649).
Thank you for your response.
On October 16, I was struck from behind by a taxi, and when I fell, I landed on my hands.
I went to the emergency room, and X-rays of my legs showed no issues.
On October 17, I experienced pain in my right shoulder and continued to feel poor blood circulation in my arm.
On October 18, I followed up with an orthopedic doctor who took X-rays and diagnosed me with frozen shoulder (which I hadn't felt before).
The bone spurs from the impact were more severe, and I was prescribed pain relief and anti-inflammatory medication.
On October 24, I consulted a neurosurgeon regarding the blood circulation issue in my arm.
The doctor suspected a possible fracture in the second cervical vertebra.
An MRI was performed on October 26, and on October 27, the doctor informed me that I had an old fracture in the second cervical vertebra that had healed, but the ligaments might have loosened.
He recommended surgery to insert screws, but mentioned that a potential side effect could be an inability to turn my head left or right post-surgery.
The doctor emphasized that treating the condition is more important.
I am a bit scared.
I would like to ask if inserting screws would help with the loosened ligaments.
I forgot to ask the doctor if the surgery is urgent, but he suggested that I should proceed quickly.
Currently, I still feel a lack of blood flow in my right arm, accompanied by some weakness and muscle pain in my upper right arm, but I do not have any swallowing difficulties.
I would appreciate your guidance.
Thank you.

Sandy, 60~69 year old female. Ask Date: 2018/10/28

Dr. Lai Zhaokang reply Neurosurgery

Hello: 1.
What you mentioned: "There is an old fracture at the second cervical vertebra, but it has healed; however, the ligaments may have become lax." Generally speaking, if there is ligament laxity at C2, the symptoms often include occipital pain.
Additionally, laxity can be graded.
If it is not severe, you might try wearing a cervical collar for conservative treatment, but it is still necessary to evaluate your imaging to make a proper judgment.
Furthermore, if surgery is performed on the C2 vertebra, some patients may be candidates for procedures that preserve cervical mobility.
2.
Regarding your symptoms: "The right arm still feels like there is poor blood flow, with some weakness and muscle pain in the right upper arm..." Generally, it is essential to review the MRI images to check for any nerve compression or edema.
Best wishes.
// Dr.
Lai Chao-Kang, Neurosurgery, Changhua Hospital

Reply Date: 2018/10/28

More Info

The issues surrounding the C2 vertebra, particularly in relation to arm circulation and potential treatment options, are complex and multifaceted. The C2 vertebra, also known as the axis, plays a crucial role in the cervical spine's structure and function, particularly in facilitating head rotation and supporting the skull. Injuries or degenerative changes in this area can lead to various neurological symptoms, including compromised blood flow to the arms, which may manifest as pain, weakness, or a sensation of poor circulation.

In your case, following the accident where you were struck from behind, it is understandable that you are experiencing significant concern regarding your symptoms. The mechanism of injury, particularly the impact and subsequent fall, can lead to various cervical spine injuries, including fractures, dislocations, or ligamentous injuries. The fact that your MRI revealed a previous fracture of the C2 vertebra that has since healed, but with potential ligamentous laxity, is significant. Ligaments provide stability to the spine, and any compromise in their integrity can lead to instability, which may affect nerve function and blood flow.

The symptoms you describe—right arm weakness, pain, and a sensation of poor circulation—could be attributed to several factors. First, the C2 vertebra is located near the cervical plexus, which is responsible for innervating the upper extremities. Any compression or irritation of the nerves in this area can lead to neurological symptoms in the arms. Additionally, if there is any instability in the cervical spine due to the laxity of the ligaments, this could potentially affect blood flow as well.

Regarding your question about surgical intervention, the recommendation to consider surgery, such as the insertion of screws or other stabilization methods, is often based on the need to restore stability to the cervical spine. Surgical stabilization can help prevent further injury, alleviate pain, and potentially improve neurological function. However, it is essential to weigh the risks and benefits of surgery, especially considering the potential for postoperative complications, such as limited range of motion in the neck.

The urgency of the surgery often depends on the severity of your symptoms and the degree of instability present. If your symptoms are progressive or if there is a risk of further neurological compromise, surgery may be more urgent. Conversely, if your symptoms are stable and manageable, a conservative approach may be considered, including physical therapy, pain management, and close monitoring.

In terms of treatment options, if surgery is deemed necessary, it is crucial to discuss with your surgeon the specific goals of the procedure, the expected outcomes, and the potential for rehabilitation post-surgery. Physical therapy is often an integral part of recovery, focusing on restoring strength, flexibility, and function in the affected arm and neck.

In summary, the relationship between C2 vertebra issues and arm circulation is significant, and your symptoms warrant careful evaluation. Surgical intervention may provide stability and improve your symptoms, but it is essential to have a thorough discussion with your healthcare provider regarding the urgency, risks, and expected outcomes of the proposed surgery. Additionally, consider seeking a second opinion if you feel uncertain about the recommended treatment plan. Your health and well-being are paramount, and ensuring you have a clear understanding of your condition and treatment options is essential for making informed decisions.

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