BP, a middle aged woman, was admitted to the Emergency Department for neck pain along with hand tingling and weakness. Her symptoms had started a few months prior, after she had been involved in a bicycle accident. But when her symptoms began worsening at a staggering rate, with a sudden increase in stabbing pain, burning, and tingling, she knew something must be wrong.

A CT and MRI showed that she had fractures on her C1 and at the base of her C2 odontoid (likely from the accident a few months earlier), with no signs of healing. Additionally, there was a mass on C1 that was noted may be metastatic. It was causing soft tissue swelling, edema, hematoma, and severe spinal cord compression.

Not only did her non-healing fractures and instability need some attention, but also her C1 vertebra needed to be assessed for cancer. However, BP was homeless and did not have the means to pay for any medical care. Thus, INI was there to help! We coordinated and covered all of the tests and treatments BP needed.

Her surgical procedure was especially complex. Imaging had not fully captured the severity of the destructive lateral mass lesion, which was causing excessive compression to the spinal cord and ventral epidural space.

She got an occiput (base of skull) to C5 (neck) posterior instrumented fusion and fixation, to solidify and stabilize her neck. Additionally, she got a spinal cord and nerve root decompression to release the tight pressure on the affected areas. As for the C1 lateral mass lesion, a portion was biopsied for pathological analysis.

“Actually kind of saved my little life there.”

Thankfully, pathology determined the mass to be noncancerous. We have been following up with BP since her surgery, and she has been recovering well. At her last follow-up visit, she expressed her gratitude for everything.

“Everything seems to be almost back to normal. Thank you!”