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.
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.
There are two types of cervical fusion procedures, anterior cervical fusion, and posterior cervical fusion.
Anterior Cervical Fusion
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.