Introduction
Many neck problems are due to degenerative changes that occur in the intervertebral discs of the cervical spine and the joints between each vertebra. Other problems are the result of injury to parts of the spine or complications of earlier surgeries. The vast majority of patients who have neck problems will not require any type of surgery. But if conservative treatments fail to control the pain, your surgeon may suggest a cervical fusion.
Learn about cervical fusion including
- how the cervical spine is affected
- what types of problems can benefit from cervical fusion
- what differentiates an anterior cervical fusion from a posterior cervical fusion
- what you can expect from this procedure including possible complications
- how rehabilitation can improve your results
- Related Document: Anterior Cervical Fusion
- Related Document: Posterior Cervical Fusion
Anatomy
In order to understand your symptoms and treatment choices, it is helpful to start with a basic understanding of the anatomy of the neck. This includes becoming familiar with the various parts that make up the cervical spine and how they work together. Learn more about the anatomy of the cervical spine.
Rationale
If it becomes apparent that surgery will be needed, there are a number of surgical procedures designed to treat various neck problems. A cervical fusion is used
- to stop the motion between two or more vertebrae
- to stabilize unstable fractures of the cervical spine
- to straighten or realign the cervical spine
The goal of a spinal fusion is to allow two or more vertebrae to grow together or fuse into one solid bone. If you are suffering from pain in the moving parts of the spine (mechanical pain), the fusion can stop the excess motion between the vertebrae and reduce your pain.
If your neck is unstable due to a fracture or dislocation of the vertebrae, the fusion stabilizes the spine. This is particularly important when the spinal cord hasn’t been injured. By surgically stabilizing the problem area in the neck, the spinal cord is protected as the neck heals. Even when the spinal cord has been damaged and the patient is paralyzed, a spinal fusion can enable the patient to get out of bed and into a wheelchair sooner. By stabilizing the spine, fusion allows the patient to begin rehabilitation earlier.
A cervical fusion may also be suggested to straighten the spine or to control a deformity of the cervical spine such as a cervical kyphosis. This is a condition where the natural inward curve of the neck reverses. This deformity occurs when the cervical spine is unstable and begins to bend forward.
Procedure
There are two types of cervical fusion procedures, anterior cervical fusion, and posterior cervical fusion.
In the anterior cervical fusion, the operation is done from the front of the neck. In the posterior cervical fusion, the operation is done through an incision in the back of the neck. A bone graft is used to connect the problem vertebrae. During the healing process, the vertebrae grow together, creating a solid piece of bone. This halts motion between the problem vertebrae, creating stability in the neck. Cervical fusion is used to treat cervical fractures, dislocations, and other pathologies. It is also used to correct deformities in the neck.
The bone graft used for cervical fusion is usually taken from the pelvis (hip) at the time of surgery. However, some surgeons prefer to use bone graft from a bone bank. This is bone that is taken from organ donors and stored under sterile conditions until needed for operations such as spinal fusion. The bone goes through a rigorous testing procedure, similar to a blood transfusion, before being used for fusion surgery.
Complications
A minimum of three months is needed for the bones to fuse together and become solid. Yet the bone graft will continue to mature for one to two years. Your doctor may have you wear a rigid neck brace or halo vest for up to three months after surgery to keep your spine still and make sure the bones fuse. You may not require a rigid brace after a simple fusion using instrumentation.
Most patients are able to return home when their medical condition is stabilized, usually within one week after fusion surgery. Limit your activities to avoid doing too much too soon. Avoid activities that put strain on the healing fusion, such as forceful bending or twisting movements of the neck. Delay activities that require heavy or forceful use of your arms, such as lifting, until your doctor determines these activities are safe.
Rehabilitation
A minimum of three months is needed for the bones to fuse together and become solid. Yet the bone graft will continue to mature for one to two years. Your doctor may have you wear a rigid neck brace or halo vest for up to three months after surgery to keep your spine still and make sure the bones fuse. You may not require a rigid brace after a simple fusion using instrumentation.
Most patients are able to return home when their medical condition is stabilized, usually within one week after fusion surgery. Limit your activities to avoid doing too much too soon. Avoid activities that put strain on the healing fusion, such as forceful bending or twisting movements of the neck. Delay activities that require heavy or forceful use of your arms, such as lifting, until your doctor determines these activities are safe.
Physical Therapy
Your doctor may have you attend physical therapy beginning a minimum of five weeks after surgery. A well-rounded rehabilitation program assists in calming pain and inflammation, improving your mobility and strength, and helping you do your daily activities with greater ease and ability. Therapy sessions may be scheduled up to three times each week for six to eight weeks.
The goals of physical therapy are to help you
- learn ways to manage your condition and control symptoms
- improve flexibility and strength
- learn correct posture and body movements to protect the fusion
- return to work safely
