What is a bone fusion surgery in neck?

Bone fusion surgery in the neck or cervical spinal fusion is a surgical procedure that involves fusing selected bones of the neck into one single solid bone. Although this reduces the flexibility of the neck, it prevents the painful motion associated with the movement.

Why is a bone fusion surgery in the neck performed?

Bone fusion in the neck may be necessary to relieve arm and neck pain associated with neck conditions such as:

Cervical radiculopathy: the nerve root is pressed by a herniated disc leading to bone spurs and nerve irritation.

Spinal instability: there is abnormal mobility between the segments of the spine leading to pain and nerve compression.

Other conditions which might need a bone fusion in the neck are:

• Rheumatoid arthritis of the bones in the neck
• Misalignment of the vertebrae
• Tumors
• Spinal deformities
• An infection

Neck fusion surgery is considered only after the other treatment options are found to be ineffective in producing the desired results.

Preparation for the surgery

Preparing in all the possible means for the surgery helps to avoid surgery related anxiety in the patient. Talk to the surgical team members and get all the doubts cleared regarding the surgery.

Other measures which the patient should take, include:

• Stop smoking and drinking alcohol for a few weeks before and after the surgery as it can have a negative impact on the healing process.
• Stop taking those medications which can increase bleeding after the surgery. These may include aspirin and anti-inflammatory medicines.
• Do not take any food or drinks for at least 8 hours before the surgery. On the day of surgery, the recommended medications may be taken only with a small sip of water.
• Have someone drive you back home.
• Have help at home to perform day-t-day activities after discharge.

Before the surgery, the doctor may need certain blood tests and x-rays.

Procedure of bone fusion surgery in the neck

The bone fusion in the neck may be performed either by making an incision in the front (anterior approach) or on the back of the neck (posterior approach). There are different techniques in doing a cervical spinal fusion. These include:

• A bone graft (small piece of bone) may be taken from other part of the body (usually from the pelvic bone) or is taken from a bone bank. This bone graft is used to form a bridge between the bones to be fused. It stimulates the growth of a new bone. Sometimes artificial fusion materials may be used.
• Metal implants are fixed to hold the vertebrae together until new bone grows between them.
• Metal plates are screwed into the adjacent vertebral bones to join them.
• The spinal disc is removed, and the neighboring vertebrae are fused.
• The entire vertebra is removed, and the spine is fused.

Finally, the incision is closed with stitches.

Recovery from bone fusion surgery in neck

The patient may have to stay for a few days in the hospital before discharge.

Recovery from bone fusion in the neck usually takes longer time compared to most of the other bone fusion surgeries as it is not possible to completely prevent pressure on the neck. Duration of recovery depends on how fast the bone graft fuses with the bones, the type of surgery, and the general health of the patient. The physician will regularly monitor the progress of healing by taking x-rays during the follow-up visits. There can be sore throat, hoarseness and swallowing difficulty for 1 to 4 weeks after the surgery.

Staying comfortable and taking certain safety measures as listed below can help in a speedy recovery:

• Wear a cervical collar or neck brace for the period suggested by the doctor.
• Avoid bending over to pick up something or bending backwards.
• Avoid sitting for long hours.
• Do not lift anything heavier than 5 lbs.
• Do not drive for at least two weeks after the surgery.
• Commit to the physical therapy program designed by the physiotherapist.

What are the risks associated with bone fusion surgery in the neck?

As with other major surgeries, the cervical spinal fusion carries certain risks such as:

• Pain at the graft donor site
• Breakage of metal implants
• Failure of fusion of the bones
• Graft rejection
• Blood clots in the deeper veins
• Excess bleeding
• Damage to the nerves and spinal cord
• Risks of general anesthesia

The risk of developing the above complications with the procedure depend on the age and overall health of the patient, and the type of surgery.