Most neck pain is caused by wear and tear that occurs in the intervertebral discs and joints of the cervical spine (neck). Many patients who have neck pain do not require surgery. However, if non-operative treatments, like epidural steroid injection or physical therapy, fail to control your pain, your surgeon may suggest a cervical laminectomy and/or discectomy with or without fusion.
Cervical laminectomy and/or discectomy with possible fusion can help to remove pressure from the nerves caused by bones spurs or bulging or herniated discs as well as stop the motion between two vertebrae if fused. The type of cervical surgery recommended by your neurosurgeon will be determined by the nature and extent of your symptoms as well as the findings on your imaging studies.
Types of Cervical Fusion
The type of fusion approach you will have is dependent on your symptoms and specific diagnosis. Talk with your doctor about the exact approach of your cervical fusion neuro-spine surgery.
Cervical Fusion with Instrumentation
Depending on the individual patient, a neurosurgeon can choose to also have metal rods, screws or hooks used in combination with the bone graft to further stabilize the spine.
For most cervical neuro-spine surgeries, patients are given general anesthesia to put them to sleep. A breathing tube may also be inserted to assist your lungs throughout the procedure.
Patients are placed on a special operating room bed that allows for optimal access to the neck and room for the surgeon to work and helps greatly reduce the potential for blood loss.
Your doctor will make a short incision in your neck to expose the correct area of the spine. An X-ray is used in the operating room to ensure that the correct bone/disc(s) is operated upon. Some neurosurgeons may also use a special surgical microscope during surgery to magnify the area they are operating upon.
Your neurosurgeon may use small cutting instruments to carefully remove soft tissue near the spinal nerves. Before cervical fusion takes place, the surgeon removes all or part of the lamina bone, takes out any disc fragments and eliminates any nearby bone spurs (laminectomy). Next, your surgeon will remove the affected (vertebral) disc, which is the cushion between your vertebrae, as well as any arthritic areas. A bone graft is then placed between the vertebrae where the disc was originally. Eventually, this graft will fuse to the surrounding vertebrae to prevent abnormal motion of the area of the neck.
At this time, your neurosurgeon may choose to fix the bones in place with a single choice or combination of metal screws, rods and plates. A fusion with instrumentation (hardware) can hold the vertebrae in place while the bone graft fuses properly. The less motion there is between the healing bones, the higher the chance of successful fusion. Instrumentation has increased the success rate of cervical fusions considerably.
(An anterior fusion may also be done in a way that spreads the vertebrae apart trying to restore the height between them.)
Once this is complete, the muscles and soft tissue is put back into place and the skin is closed with sutures, staples, skin glue or steri-strips (small pieces of tape).
Your length of cervical surgery recovery time in the hospital will depend on the reason that you needed to have cervical spine surgery. Most patients go home the day after surgery, but your surgeon will decide when you are ready for discharge.
If you require some rehabilitation before going home, a doctor from the Physical Medicine and Rehabilitation department will see you and make specific recommendations regarding your discharge.
You need to be able to walk, eat, urinate, and your surgical wound must be healing well.
Contact your doctor immediately if you have:
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