What Is Cervical Fusion?

Cervical fusion is the surgical procedure of fusing together vertebrae in the cervical spine, which consists of seven vertebrae separated by six intervertebral discs. Cervical fusion can involve any adjacent vertebrae in the cervical spine.

Why Is It Done?

A cervical fusion may be performed to stop excessive movement between two vertebrae in the cervical spine. This movement can occur for a variety of reasons. For instance, perhaps a herniated, ruptured, or bulging disc is causing abnormal pressure in an area of the cervical spine. To eliminate the pressure, the disc is removed. The resulting void creates an instability in the cervical spine, leading to movement between the vertebrae. To remedy this problem, the void can be filled with a bone graft. If successful, the two vertebrae will become fused together into a single bone mass.

Instead of a bone graft, a titanium cage packed with material to help new bone to form may be inserted into the void left after a disc is removed.

Cervical fusion may also be necessary in cases where two vertebrae are not properly aligned, a condition known as spondylolisthesis. This misalignment, which can cause abnormal movement between the two vertebrae, can typically be fixed by a successful cervical fusion.

Other conditions that may damage the cervical spine and require fusion include tumors, infections, congenital spinal deformities, spinal injuries, fractures, or arthritis affecting the spine.

Procedure

To perform a cervical fusion, the surgeon must gain access the cervical spine. This is most commonly done through the front of the neck. After locating the two vertebrae to be fused, the surgeon removes the disc separating them. Any bone spurs discovered are also removed at this time. The surgeon then measures the space between the two vertebrae and inserts a bone graft or cage of the appropriate height.

Often, the surgeon screws a metal plate over the affected area in order to provide reinforcement and stability during the fusion process. In the months following the surgery, the vertebrae will fuse with the bone graft or cage to form a continuous bone mass.

The fusion process usually takes about three months to be completed. To encourage proper fusion, it may be necessary for the patient to wear a cervical collar during the process.

Benefits

Cervical fusion can potentially relieve neck pain and related symptoms after more conservative treatments have failed. Though fusing two vertebrae together essentially reduces the number of cervical vertebrae from seven to six, this does not significantly diminish mobility in most cases.

Risks

There are, however, other potential complications from a cervical fusion. Sometimes the bones fail to fuse properly, a condition known as pseudarthrosis. This happens most commonly with smokers. It is also possible for the bone graft to fracture, which has motivated many surgeons to use titanium cages.

Less common is the danger that the screws used to fix the metal plate loosen. Also, if the surgical wound does not heal properly, an infection may set in. Other risks include the potential for blood clots, excessive bleeding, and nerve damage. Specifically, damage caused to the nerves connected to the larynx (voice box) can cause hoarseness.

Anesthesia has risks too, which are heightened in patients who have other medical conditions. It is important to discuss these risks with your surgeon before you consider surgery.

Tom Wascher M.D. will review your imaging studies free of charge or, if needed, provide you with a second opinion. He has performed over 1,800 cervical surgeries during his career and wants to see that you receive the best treatment possible. He is a competent and caring surgeon who has your best interests in mind.