Cervical fusion is a surgery that can treat a wide variety of complex diseases beyond what disc replacement can achieve. The main goals are decompressing the nerves and spinal cord and stabilizing the neck in proper alignment.
While cervical disc replacement is a great technology for many patients, cervical fusion is still necessary for many patients to address complex pathologies. Cervical fusion involves fusing the bones together usually involving removal of the discs and placement of hardware to hold the bones in place while they heal. Some loss of range of motion is expected but in cases of fracture, severe arthritis, or severe deformity, this actually does make sense.
- Cervical stenosis
- Cervical disc herniation
- Cervical foraminal stenosis
- Cervical degenerative disc disease
- Instability of the bones of the neck
- Fracture of the neck
- Cervical deformity and scoliosis
Cervical Fusion Procedure
- Kyphosis of the neck
- Cervical tumors and cancer
- Congenital neck abnormalities
- Failed disc replacement
- Failed cervical fusion
- Many more diseases
Cervical fusion is performed from the front of the neck (anterior), the back of the neck (posterior), or in complex cases from both the front and the back (360). Anterior surgeries of 2 or less levels are generally outpatient procedures but more levels usually require a short hospital stay. Posterior surgeries often require more days in the hospital as they are more invasive in general compared to anterior surgeries. Anterior fusions are often called ACDF’s short for Anterior Cervical Discectomy and Fusion. Posterior surgeries are call Posterior Cervical Fusions.
Anterior Cervical Discectomy and Fusion
The approach is from a small incision in the front of the neck. The disc and bone spurs are removed off of the nerves carefully using a microscope for the delicate work around the nerves and spinal cord. Once the pressure is alleviated, a spacer is placed where the disc used to be. It is not mobile but acts as a strut to restore some height and shape that the disc lost. A small plate may be used to secure the bones together.
A simple 2 level ACDF takes about 1 hour to complete and is generally well tolerated.
Posterior Cervical Fusion
Posterior cervical fusions involve making an incision in the back of the neck. The bones are exposed carefully and when needed, bone can be removed off the nerves carefully. Screws are then placed in the bones avoiding critical structures.
The posterior approach is generally more painful than an anterior approach but can be more useful from some patients based on their pathology. The recovery is longer usually due to the more extensive muscle work that is involved in these approaches.
Cervical fusion resources
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Legacy Spine Clinic
24900 SE Stark St, Suite 109
Gresham, OR 97030
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