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Hello @dancarpenter. If you would like to find your way into a discussion on cervical spinal fusion, I would invite you to consider one of the following:

- Cervical Neck Instability: https://connect.mayoclinic.org/discussion/cervical-neck-instability/
or
– Spinal fusion of C1-C6: https://connect.mayoclinic.org/discussion/spinal-fusion-of-c1-c6/

The second discussion is the one where I moved your first post, for reference.

@dancarpenter Dan, C1 & C2 do most of the motion for turning your head with a little bit of help from C3 and C4. You would loose significant motion if they are fused. I'm sure that is a hard choice to make. If you have instability at the upper levels there, that can also be bad as it can impact the spinal cord if it gets compressed by a moving or slipping vertebrae or disc. My surgeon told me that the Phrenic nerve exits the spinal cord somewhere near C3, so if you damage the cord above that level, it can affect anything below it which could include a compromise to breathing or your heart. You need a real expert surgeon for that. Many surgeons don't want to operate above C3 because of those risks. My physical therapist tells me that instability at C1 and the skull can cause a fatality, so these issues need to be completely understood by any therapist or doctor who treats you.

Are you able to turn your head now with your injury? I'm guessing, you may have a physical therapist, and they would be a great source of information for a question like that as to how your motion would change after fusion surgery. There are surgeons who specialize in skull base surgery who work in the upper levels. You need a surgeon who's interests match what you need; someone who wants the challenge of a more difficult surgery. Have you considered getting a consult at Mayo? They have many sub-specialties among their spine neurosurgeons. I am a Mayo spine surrey patient and had a C5/C6 fusion. My head turning range is exactly the same as before my surgery because those levels are not involved. Once you are fused, there is more stress on other levels that can lead to adjacent discs going bad. That can happen to people who don't have spine surgery too, and to people with artificial disc replacements, but doctors think the statistics of this happening is a bit higher with fusion surgeries. You could seek an opinion with a surgeon who does both fusion of artificial disc replacement. There are risks to artificial discs too, and they can fail or migrate, so there is a lot to consider in what would be your best choice.

Have you had several opinions? That may be very important for you. You don't just need a surgeon, you need an expert gifted surgeon because you have one chance to get it right when you go through surgery, and it can't be undone with few exceptions. (Sometimes if an artificial disc fails, it is removed, and the spine is fused instead.) Choose carefully and ask a lot of questions at your consultations.