Cervical Spinal Fusion

Surgery Overview

Cervical spinal fusion is surgery that joins two or more of the vertebrae in your neck. When these bones are joined together, it's called fusion. After the joints are fused, they can no longer move.

During the surgery, the doctor uses bone to make a "bridge" between your vertebrae. This bridge may be strengthened with metal plates and screws. In most cases, the doctor uses bone from another part of your body or bone that has been donated to a bone bank. But sometimes human-made bone is used.

To do the surgery, the doctor makes a cut in either the front or the back of your neck. The cut is called an incision. It leaves a scar that fades with time.

After surgery, you will have a short hospital stay. Your neck will feel stiff or sore. You will get medicine to help with pain.

Most people can go back to work after 4 to 6 weeks. But it may take a few months to get back to your usual activities.

What To Expect

This surgery usually requires a short stay in the hospital. You may need to wear a brace on your neck (cervical collar) while you recover.

Why It Is Done

Cervical spinal fusion joins two or more vertebrae in the neck to make the neck more stable. It may be done:

• After an injury. This can help prevent a bone fracture from causing instability or damage to the spinal cord, which may result in paralysis.
• To treat conditions such as misalignment of the vertebrae or spinal deformities.
• In combination with decompressive surgery to decrease pressure on the spinal cord and/or spinal nerves in the neck. The pressure can be caused by things like spinal stenosis, a herniated disc, or the effects of rheumatoid arthritis.
• Because of an infection or a tumor.

How Well It Works

Often spinal fusion is needed to keep the spine stable after injury, infection, or a tumor.

The research on how well surgery helps people is not clear. When symptoms such as numbness or weakness in the arm suggest that a neck problem is causing a pinched nerve (radiculopathy), surgery may help you feel better faster. Small studies show that people may have improved symptoms, like better hand function, a few months after surgery compared with those who did nonsurgical treatments, like physical therapy. But surgery may not be any better than nonsurgical treatment in the long run. ^{footnote 1}

If you have neck pain alone, with no signs of a pinched nerve, spinal fusion surgery will probably not help.^{footnote 2}

Risks

Cervical spinal fusion can cause the part of the neck that is fused to be stiff. If two vertebrae are fused together, it doesn't reduce neck flexibility for most people. But if more vertebrae are fused, the neck may be stiff.

Surgery and the use of anesthesia involve some risk. The risks associated with this procedure vary depending on your age and overall health, diagnosis, and type of procedure used. Risks include:

• Pain in a bone graft site (donor site) if bone from another place in the body is used.
• Failure of the fusion, breakage of metal implants (if used), or both.
• Blood clots in deep veins.
• Nerve or spinal cord injury.
• Graft rejection.
• Infection.
• Excessive bleeding.
• Risks of general anesthesia.