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Posterior Cervical Fusion

NuVasive

This webpage is designed to inform you about the Posterior Cervical Fusion (PCF) surgical procedure. It is not meant to replace any personal conversations that you might wish to have with your physician or other member of your healthcare team.

Not all the information here will apply to your individual treatment or its outcome. The information is intended to answer some of your questions and serve as a stimulus for you to ask appropriate questions about the procedure.

PCF is the technique of joining the bones in the back of the cervical spine together. Over time these small bones fuse together to form an internal brace and stabilize the cervical spine, reducing painful motion or spinal cord compression.

The benefit to the patient is stabilization, possible reduction in pain, reduction in continuing degeneration, and maintaining stability after a laminectomy (surgery to remove the lamina or back part of the vertebra that covers your spinal canal to relieve pressure on the spinal cord or nerves).

 

Rest, heat, electrotherapy, physical therapy, and pain medication are all options to help treat your symptoms. You should talk to your physician about all viable options for your specific symptoms.

If your symptoms do not improve with other methods, your physician may suggest spinal surgery. Surgery is reserved for those who do not gain relief from non-operative forms of treatment, patients whose symptoms are increasing or worsening, and/or patients that present with a spinal condition that indicates the need for surgery.

In the cervical spine (neck), surgery is often performed via the posterior approach to address a multitude of indications, including degenerative disc disease, dislocation, fractures, instability, or soft disc herniation. Your physician may determine that the PCF procedure is a good option for you if you require an interbody fusion, are skeletally mature, and have gone through six weeks of non-surgical treatment.

Conversely, your physician may determine that a PCF procedure is not a good option for you if you are not a good candidate for fusion surgery in general due to other medical conditions. These conditions may be associated with a poor tolerance with regard to general anesthesia, inability to tolerate a prone position, and inadequate bone quality preventing adequate fixation of the instrumentation, as well as other indications. It is important to discuss this with your physician in order to determine the best course of treatment for you.

Are there risks involved?

Keep in mind that all surgery presents risks and complications that are important to discuss with your physician prior to your surgery. Listening to your physician’s guidance both before and after surgery will help to ensure the best possible outcome from your procedure.

Risks associated with PCF include: axial neck pain, morbidity (incidence of disease), stiffness, loss of range of motion, paralysis, bleeding requiring a blood transfusion, failure of the fusion, failure of the instrumentation, nerve root injury and dural tears.

Your physician will review your condition and explain all of your treatment options, including medications, physical therapy, and other surgeries such as removal of the diseased disc, fusion, etc. You will be required to fast the evening before surgery and you may need to stop taking some medications in advance of the procedure. These medications may include aspirin and nonsteroidal anti-inflammatory drugs, as well as blood thinners. Additionally, all nutritional supplements need to be stopped at least one month prior to surgery. Before your surgery you will meet with a spine surgeon to review the surgery, the area of the cervical spine being operated on, and sign consent forms. He or she will discuss potential risks and benefits of the procedure and this is a good time to ask questions. You may be measured for a cervical collar or brace prior to surgery. Your surgeon may also schedule you for a pre-surgical medical evaluation.

An incision is created over the treatment area at the midline of the back of the neck.

Some removal of impinging bone may be performed (laminectomy or facetectomy) if direct spinal cord decompression is necessary.

Instrumentation is inserted to provide stabilization at the treated levels. Rod systems with hooks and screws are the most common instrumentation used in this surgery; they increase stability and rate of fusion. Rods will then be contoured and inserted to fit the space. The rods will be secured in place with locking screws.

Once the instrumentation has been secured in place, fusion can occur.

You may or may not need a neck brace after surgery. This is dependent upon your surgeon and the specific procedure, as well as the number of levels involved. You may experience postoperative pain as well as muscle spasms at your surgical site. This is well controlled with pain medications and muscle relaxers that can be prescribed by your surgeon. It is not uncommon to spend the first night or two with the head of your hospital bed elevated to decrease pain and swelling. Often times, there is a small drain tube that is removed on the first or second day after surgery; this is painless. Physical and occupational therapy is sometimes needed after surgery to help restore you to your normal activities of daily living. You will likely be advised against bending, twisting, and lifting for a period of time after your surgery. You cannot drive a car until you are out of your cervical collar, have sufficient neck range of motion to see while driving, and are no longer taking pain medication. You can, however, be driven or fly on a plane as soon as you feel up to it. Your physician will provide instructions on wound care, exercises, and limitations to postoperative activity.

 

CAN I SHOWER AFTER SURGERY?

Depending on your surgical incision, you may have showering restrictions. Ask your physician for appropriate instructions.

WILL I HAVE A SCAR?

This surgery involves a small incision on the posterior (back) of your neck. Ask your physician for more information as every patient is different.

WHEN CAN I DRIVE?

For a period of time after your surgery, you may be cautioned about activities such as driving. Your physician will tell you when you may drive again.

CAN I TRAVEL?

The implants used in the PCF procedure may activate a metal detector. Because of increased airport security measures, please call your local airport authority before traveling to get information that might help you pass through security more quickly and easily. Ask your physician to provide a patient identification card.

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