Surgical Procedures
ANTERIOR CERVICAL SURGERY


1. WHAT IS ANTERIOR CERVICAL FUSION ?

An anterior cervical fusion is surgery designed to take two, or more, vertebrae in your neck and "weld" them together with a piece of bone. The bone is usually taken from your pelvis, or it may be donor (cadaver) bone. It is placed between the vertebrae in the front (anterior) part of your cervical spine. The bone is placed in the area of the spine that has been removed because it is degenerated and causing nerve compression. Usually, It takes the body approximately 3 months to fuse these segments together solidly.

2. WHAT ARE THE DETAILS OF THE OPERATION?

The procedure takes about 2 hours to perform. An incision is made across the front part of your neck. The incision goes past your esophagus and trachea (breathing and swallowing tubes), and your spine is directly under this area. Depending on the problem, disks or the front part of the vertebral body (corpectomy) may need to be removed. The decompressed area is then bridged with a bone graft strut. A metal plate may be screwed in place over the spacer. After surgery, you are usually somewhat hoarse, and there is some difficulty involved in swallowing for 3 to 4 days. This is quite common. You can get up and around the day of surgery and will be required to wear a soft collar.

3. WHAT IS THE POSTOPERATIVE COURSE LIKE?

For a single-level fusion, we use a soft collar for immobilization. For multiple levels, we usually recommend a more rigid collar. The soft or rigid collar immobilization will continue for 6 weeks after the surgery. After that, we will have you wear the soft collar just for sleeping. Usually by 3 months, we can tell by x-ray if the fusion is healed.

4. WHAT IS THE SUCCESS RATE?

If the disease is localized to one level of your neck, there is approximately a 75-85% chance you will benefit from the operation. Thus, there is a 15-25% chance that the surgery will do you little, if any, good. The chance of benefit for a two-level fusion drops to 60-70%, and for a three-level fusion, to 50%. There is a chance that the symptoms may be worse; however, the chances are slight. The goal of the surgery is to give you enough pain relief to feel that the surgery was worthwhile, but rarely do we attain absolutely complete pain relief. We believe that this is because there are so many pain-producing areas in the cervical spine. It is our feeling that with a cervical fusion we are attempting to eliminate the greatest source of pain.