What is Cervical Fusion Surgery and How it is Done?

Cervical Fusion Surgery

Cervical fusion surgery is a procedure that permanently “fuses” or connects at least two cervical vertebrae. The cervical portion of the spine is located in the uppermost section of the back, in the area of the neck. Your vertebrae are also called your backbones. One single backbone is known as a vertebra.

Cervical fusion surgery is sometimes completed through an opening or incision made in the front of the body. This is called an anterior cervical fusion. If the spinal column is accessed through an incision made in the back of the neck, the procedure is called posterior cervical fusion surgery.  

What conditions does cervical fusion surgery treat?

Cervical fusion surgery is often used as a treatment for severe neck pain that travels down into the arm due to compression, irritation, and inflammation of the spinal nerves. Doctors may also recommend cervical fusion surgery to treat the following people:

  • Patients who have spinal instability
  • Patients whose pain is due to problems in the cervical discs of the spine
  • Patients whose symptoms persist or worsen despite conservative (non-surgical) treatments
  • Patients who are risk for damage to the spinal cord due a traumatic injury  

Cervical fusion surgery: Preparation

You will be given specific pre-op instructions by your surgeon, but there are a few general pre-operative suggestions you can follow to help your surgery go more smoothly.

  • Avoid constipation. If you are scheduled for cervical fusion surgery, make sure your bowels are functioning well prior to your operation. A good way to do this is to take a gentle laxative or stool softener, like senna or colace, two days before your cervical fusion surgery.
  • NPO. This is medical shorthand for “nothing by mouth.” Your doctor will tell you exactly when you need to stop eating. As a general rule, you cannot eat or drink after midnight on the day you are scheduled for cervical fusion surgery. You may be able to take your morning medications with a small sip of water.
  • Medication. Make sure you doctor knows what medications you take prior to being scheduled for surgery. This includes prescription and over-the-counter medications, supplements and any herbal or natural preparations. If you are on blood thinning medications, aspirin, or anti-inflammatory medications, you will probably have to stop these several days before cervical fusion surgery to reduce the risk of excessive bleeding.
  • Shower. The evening before your cervical fusion surgery and the morning of your operation, you might be instructed to take a shower using anti-bacterial soap. It’s important to dress in clean pajamas or clean clothing after showering, and to have clean linens on your bed. Your skin will be cleaned at the hospital before your cervical fusion surgery, but these steps at home help reduce the risk of infection.  

How is cervical fusion surgery done?

  • Anterior cervical fusion surgery: In anterior cervical fusion surgery, completed through an incision in the front of the neck, the damaged or diseased disc(s) is removed. An artificial disc or a bone graft is then inserted where the disc(s) was removed. The graft or artificial disc, along with a small plate, helps the area maintain the correct height while the body heals. As healing occurs, a solid piece of bone forms across the space where the disc was located.
  • Posterior cervical fusion surgery: In surgery completed through an incision made in the back of the neck, the muscles that overlie the top of the vertebrae are first gently moved over to the side to expose the damaged or diseased disc(s). In posterior cervical fusion surgery, rods or plates are typically connected to the vertebrae with surgical screws and this surgical instrumentation holds the vertebrae together. The bone graft is placed to the side of the vertebrae to help them fuse. The posterior approach to cervical fusion surgery is usually more painful than the anterior approach.

What to expect after cervical fusion surgery

In most cases, patients wake up following cervical fusion surgery in the recovery room. In many hospitals and surgery centers this is called the PACU, or Post-Anesthesia Care Unit. Your condition in the PACU will be monitored while you wake up and your condition will be stable before you are transferred to a room on the surgical unit.   

To help make sure you are comfortable following cervical fusion surgery, your physician might want you to use a Patient Controlled Analgesia (PCA) pump. This device is connected to your IV (intravenous) line and you can administer your own medication by pressing a button on the pump. PCA pumps are designed with a lockout feature that prevents you from giving yourself too much medication.

Soon after cervical fusion surgery, you will be helped to get out of bed by the nurses or physical therapists. You will be taught safe ways to move and walk. You may become dizzy when you first sit up and move around. This is normal. As you regain your strength, dizziness and lightheadedness will decrease.  

Some surgeons prescribe cervical or neck collars for their patients to wear following cervical fusion surgery. This helps support and protect the surgical portion of the spine. Physical therapists help with fitting the collar and you will be given instructions related to when and for how often to wear it. 

Your cervical fusion surgery incision will be cared for by the nurses while you are in the hospital. Before discharge from the hospital, you will be instructed on how to care for the incision yourself.

Going home after cervical fusion surgery

It is very important that you understand and follow your doctor’s instructions when you leave the hospital after cervical fusion surgery. Some of these instructions may include:

  • Neck brace: If you have been fitted with a neck collar or brace, wear it exactly according to your doctor’s instructions.
  • Rest: It is important to rest so your body can heal. This will take from 6 to 8 weeks after cervical fusion surgery. You don’t have to stay in bed. You can walk around the house, but avoid strenuous activity. Don’t lift anything heavy. Take only short walks. Take life easy.
  • Don’t drive: You can most likely ride in a car, but you won’t be allowed to drive a car for about six weeks after cervical fusion surgery. When riding, stop frequently to get out, stretch, and change positions.
  • Flying: You can probably fly on an airplane, but there may be problems in the airport if you try to travel alone after cervical fusion surgery. You cannot carry luggage or try to lift it off the luggage racks or carousels until the fusion is healed. You should not stand in long lines or sit for prolonged periods.
  • Work: You will need your surgeon’s permission to return to work. This will vary, depending on what type of work you do. If you work at a desk, you may be able to return to your job sooner than someone whose job requires lifting. Some people cannot return to work until X-rays reveal the cervical fusion is complete.

Rehabilitation following cervical fusion surgery

Most patients return to their surgeon for follow-up approximately six weeks after cervical fusion surgery. X-rays taken at this time usually show healing and physical therapy is often started. Therapists begin with simple gentle exercises and advance to strengthening programs. Many patients are back to their normal activities within about three months after cervical fusion surgery.  You may be followed by your surgeon every few months for approximately a year to make sure the fusion is healing correctly.