Health concerns: cervical fusion/spinal cord injury

[Skittl1321]

I am very new to diving, just signed up for a certification course next month, so not even 'new to diving' as I'm not there yet! I am trying to figure out if there is any contraindication to my health history and diving. The problem is, I'm not really even sure what doctor to ask. I don't have a neurosurgeon here, and I really don't think my primary care NP knows enough about the specifics of both spinal concerns or diving to answer well.

I broke C5 in 1999, and have a C4-C5-C6 cervical fusion (bone graft + metal plate). I have a spinal cord injury, in that there is a small hole in my cord from where the bone hit it (temporary paralysis was resolved with time and therapy), but have more or less zero effects from it. Although I have less range of motion than what I did before, it is in the normal range. I have been cleared for all 'non whiplash' activities (so no roller coasters or bungee jumping) for over 13 years. For 12 years I've not been restricted in weight I can carry beyond what I'm able to do.

I have read many posts from people with cervical fusions who dive, and I have even seen that diving is being used as therapy for those with spinal cord injuries- so I am thinking there is no reason these should effect me. But then I read something about scar tissue blocking oxygen to the spinal cord?

Does anyone know anything about precautions I might need to take or reasons I shouldn't dive?

 

[TSandM]

If you are asymptomatic and have a reasonable range of neck motion (so that you can position yourself more or less horizontally and still see in front of you) I can't think of any reason this injury or procedure should impact your diving. There is a theoretical concern about increased susceptibility to decompression injury in scar tissue, because it doesn't have a great blood supply, but I am unaware of any studies that indicate that this actually happens, and there are a great many people (myself included) out there diving with various plates and screws in them without issue.

I know of several people who are diving after cervical fusions. The plural of anecdote is not data, but it's the best I have.

 

[kombiguy]

I don't know about fusions, but I had a C1-C6 laminectomy in 2007 due to Brown-Sequard syndrome. My spinal surgeon said no problems with a return to diving, and so far I have had no ill effects. This is 300+ doves later, including deco diving in the 200 ft. range.
As TSandM noted, however, the plural of anecdote is not data.

 

[LowDrag]

My wife had C4 & C5 fused together last October and has been cleared by her doctor to finally get back in the water. I have seen others here suggest calling DAN and see what they say seeing as you don't have a neural surgeon you can talk to. They could give possibly give you some information that you could use I bet.

 

[Skittl1321]

Will DAN talk to me if i am not yet a member?

I'm thinking that I should probably be okay. So the dive shop just wants my primary care to sign off- and I'm sure she will. I just kind of felt like she is unlikely to know anything about this (being neither a spine specialist or a diver) so I kind of wanted some idea that I wasn't doing something really stupid! After my accident I kind of had a 'scared of everything' problem, so I likely won't dive very deep, and I'm guessing any major problems come with great depth.

 

[divingpyrate]

completed my AOW 6 weeks after surgery with strict medical supervision
no problems at all
C5-C6 fussion, my nerves were completely crushed
all but feeling in my left index have returned and no worries diving at all

 

[Skittl1321]

completed my AOW 6 weeks after surgery with strict medical supervision
no problems at all
C5-C6 fussion, my nerves were completely crushed
all but feeling in my left index have returned and no worries diving at all

Thanks for sharing your experience. Surely you were an experienced diver- but I can't imagine doing AOW 6 weeks post surgery! I was barely able to exert any energy at that point, couldn't even walk a half-mile without being tired. I have an appointment with my primary care, but even if she will sign off (I'm a little worried she will decide she isn't informed enough to say either way!) I kind of wanted reassurance that this wasn't a stupid idea.

I have pretty much NO neurological signs under most conditions. I can't handle cold air blowing across my wrists, and I have a callus on my thumb in a spot where I don't have feeling, but it is just bigger than a pencil eraser. Coming from complete (but temporary) paralysis when I was taken to the ER, I consider that miracle enough for me.

But still, if diving was just going to be stupid thing to undertake, I don't want to be doing it.

 

[kaerius]

Will DAN talk to me if i am not yet a member?

Yes. The medical advice part is separate from the insurance part. Different organizations under the same umbrella.

 

[Skittl1321]

I did call DAN. They gave me a bit of information about the scar-tissue issue and a referral to a local dive medicine physician who might be able to do my physical.

The local physican turned out to be the head of hyperbaric unit at the hospital! I talked with another MD in the unit (who has some dive training) and she said they don't really do that sort of thing, and that they would likely end up reviewing my case and calling DAN for more information, but if my NP doesn't feel comfortable signing off, they will be happy to see me. She highly encouraged me to SCUBA dive and told me it is one of her great enjoyments in life.

It sounds like the scar tissue around my spinal cord does mean I need to be more vigilant due to susceptibility to DCS, but that as long as I am a safe diver, watch my (whatever you watch... I haven't gotten this far yet) and don't dive too deep (not sure what too deep is, but I'm a weeny, so I'm sure this won't be an issue) I should be good to go.

This makes me feel a lot better to have talked to someone in the hyperbaric unit who thinks diving is not a bad idea! Now I just have to go to my physical and get the forms signed by my NP.

 

[Quero]

One thing that hasn't been mentioned is how nice it is to be 'weightless' in the water when you've got some joint issues. I suffered several whiplash injuries, one of which required traction several times a day for six months and one which left both of my arms paralyzed for a period of time (since reversed) with C5-C6 involvement. I have not needed corrective surgery, very luckily, but I still get tingling and numbness in certain positions and my hands are always a bit weak. What I find is that the neutral buoyancy I achieve while scuba diving is much more comfortable for me, even with a flexed neck, than activities like bicycling, so I find it wonderfully liberating to be in the water strain/pain free!