Neck fusion, also known as cervical spinal fusion, is a surgical procedure designed to address issues within the neck portion of the spine. It permanently joins two or more of the seven bones, or vertebrae, in the neck into a single, stable bone unit. The primary aim of this fusion is to eliminate motion between the affected vertebrae, which can help alleviate pressure on nerves or the spinal cord.
The process creates a “bridge” between the vertebrae using bone material, which encourages them to grow together over time. To support this healing and provide immediate stability, surgeons often use metal plates, rods, and screws. This approach helps to stabilize the cervical spine, reducing irritation to surrounding nerves, ligaments, and muscles.
Defining Neck Fusion
Cervical spinal fusion aims to stabilize the spine by stopping movement between specific vertebral segments. The human spine, including the neck, is composed of stacked bones called vertebrae, cushioned by discs that allow for flexibility. When these discs or vertebrae are damaged, it can cause pain and instability.
The core concept involves placing a bone graft, which can be from the patient’s own body, a cadaver, or a synthetic material, into the space between the vertebrae. This graft acts as a scaffold, promoting new bone growth that eventually fuses the adjacent vertebrae. Metal hardware, such as plates and screws, is typically used to hold the vertebrae securely in place while this fusion process occurs.
Reasons for Neck Fusion
Neck fusion surgery is generally considered when non-surgical treatments have not provided sufficient relief for persistent neck pain or other symptoms. It is often recommended for conditions that cause instability, nerve compression, or structural problems within the cervical spine. These conditions include a herniated disc, where the soft cushioning material between vertebrae protrudes and presses on nearby nerves or the spinal cord.
Spinal stenosis, a narrowing of the spinal canal that can compress nerves, is another common reason for fusion. Cervical instability, which involves excessive motion between vertebrae, or issues arising from arthritis, tumors, and fractures can also necessitate this procedure. By stabilizing the affected area, neck fusion aims to alleviate symptoms such as pain, numbness, or weakness that radiate into the arms or hands. The goal is to correct misaligned vertebrae and prevent further damage to the spinal cord after an injury or due to degenerative conditions.
How Neck Fusion is Performed
Neck fusion surgery typically begins with the patient under general anesthesia, ensuring they are asleep throughout the procedure. Surgeons commonly access the spine through the front of the neck, known as an anterior approach, which often involves a small horizontal incision. This approach allows direct access to the discs without disturbing the spinal cord or major neck muscles from the back. In some cases, depending on the specific issue, a posterior approach through the back of the neck may be used, particularly for stability at the rear of the neck or for certain fractures.
Once the incision is made, the surgeon carefully moves aside muscles, the trachea, and the esophagus to expose the cervical vertebrae and discs. If a damaged disc is causing the problem, it is removed in a procedure called a discectomy. Any bone spurs that might be compressing nerves are also removed. The empty space left by the removed disc is then prepared to receive a bone graft.
The bone graft is inserted into the disc space to act as a bridge for the fusion. To provide immediate stability and hold the vertebrae in place while they fuse, metal plates and screws are securely attached to the adjacent vertebrae. The surgeon then closes the incision, and the patient is moved to recovery.
Recovery and Rehabilitation
Following neck fusion surgery, patients typically have a short hospital stay for a few days. Pain management is a priority during this immediate post-operative period, with medication administered to help control discomfort. The neck may feel stiff or sore as it heals.
During the initial weeks of recovery, activity restrictions are common to protect the fusing vertebrae. This often includes avoiding heavy lifting, strenuous activities, and sudden movements of the neck. Many patients are advised to wear a cervical collar or brace, which provides external support and helps limit neck motion, promoting proper fusion. Full fusion of the bones is a gradual process that can take several months, sometimes up to a year or more.
Physical therapy plays an important role in rehabilitation. Therapy focuses on regaining strength and mobility in the neck and upper body. Adhering to medical advice and following the prescribed rehabilitation program are important for a successful outcome, as this allows the bones to properly fuse and helps the patient return to their usual activities.