Step-by-Step Posterior Cervical Spinal Fusion

Posterior cervical spinal fusion is a surgical technique used to treat injury or degeneration in the bones (vertebrae) of the neck that cannot be addressed through more conservative methods. It involves permanently joining one or more vertebrae to minimize movement, straighten the neck, stop progressive deformities or provide stability after a dislocation or fracture.

Surgical Steps

• In a spinal fusion, small sections of bone known as bone grafts are placed between one or more vertebrae. Over time, these grafts will fuse to the vertebrae, effectively creating a single larger section of bone. According to the University of Maryland Medical Center, your bone graft material may be taken either from your own body or from a donor bone bank. If your own bone is used, the first step in your cervical fusion procedure will be surgical removal of a section of bone from your hip. If donor bone material is used, your surgeon will pre-screen the graft to make sure it is free of disease and optimally suited for your body.

  In the next step of the procedure, your surgeon will make an incision up the back of your neck that may be 3 to 6 inches long, depending on the number of vertebrae to be fused. He will then spread apart the muscles and connective tissue in the area and expose the rear sections of your vertebrae, known as lamina. At this stage, X-rays will be taken to provide a clear image of the surgical site. Depending on the overall goals of your treatment, your surgeon may then perform a number of procedures prior to your cervical fusion, including a laminectomy (removal of your lamina) or a foraminotomy, which involves widening of the nerve channels that pass through your vertebrae.

  In the next step, your surgeon will lay your bone grafts vertically over the rear of your vertebrae, aligning them in a way that will encourage the vertebrae to fuse together over time. To keep the grafts in place while the bones fuse, your surgeon will use any one of a number of artificial materials, referred to generally as instrumentation. Available options here include plates and screws, rods, hooks, cables and mesh cages. Whatever material is used, it will stabilize the vertebrae during fusion, and over time will become encased in new bone growth as fusion progresses. In some cases, your surgeon may also choose to immobilize your neck externally using a device called a halo. If this is true for you, a semi-circular metal segment will be attached to the bottom of your skull with pins. Your surgeon will then connect a series of rods to this segment that will act as an anchor for a plastic or plaster cast.

After Surgery

• In the aftermath of surgery, you will receive powerful painkillers to diminish your discomfort. You will also be encouraged to use your neck as soon as possible to enhance your recovery and lower your chances of post-surgical complications. Consult your surgeon for more details on your procedure.