Consider that to complete the square it is necessary to add 9 both sides:
[tex]\begin{gathered} x^2+6x+9=18+9 \\ (x+3)^2=27 \\ (x+3)^2-27=0 \end{gathered}[/tex]Then, you have a difference of squares, whose factorization is:
[tex](x+3)^2-27=(x+3+\sqrt[\placeholder{⬚}]{27})(x+3-\sqrt[\placeholder{⬚}]{27})=0[/tex]Then, the solutions for x are (by making each factor equal to zero):
[tex]x=-3\pm\sqrt[\placeholder{⬚}]{27}[/tex]Hence, the answer is option C.