Posterior Cervical Fusion
Posterior cervical fusion is a surgical procedure performed through the back of the neck for the fusion of two or more cervical vertebrae into one solid bone. The fusion of the vertebrae prevents their movement and is done to relieve pain associated with neck movement, stabilize the cervical spine and prevent injury to the spinal cord. It is commonly indicated in the management of neck fractures, dislocations and correction of the abnormal curvature of the cervical spine (kyphosis).
The procedure is performed under general anaesthesia. The patient lies face down on the operating table and the head is fixed in position with a special device called Mayfield. A vertical incision is made over the neck, in the mid-line just above the level of the damage. The neck muscles are retracted, and the cervical spine is exposed for the surgery. The surface of the lamina of each vertebra to be fused is shaved off (laminectomy) to stimulate fusion through bone healing. Two titanium metal rods are then fixed to either side of the vertebra with the help of two screws. This instrumentation stabilizes the cervical spine. The incision is then sutured. In most cases the patient is discharged after one to three days of the surgery.
After the Surgery
Slight pain around the incision site and spasms of the neck muscles are common and usually resolve within a week of the surgery. The incision should always be kept clean and dry. The bandaged area should be covered properly to prevent it from getting wet, especially while bathing. Patients are advised to avoid lifting, bending or twisting of the neck for four to six weeks after the surgery. The patient may be advised to wear a neck brace. The patient may resume work, with some restrictions, as early as four to six weeks after the surgery.
Risks and Complications
The risks associated with posterior cervical fusion are low but may include infection, bleeding, nerve damage and leakage of spinal fluid.