The cervical spine is made up of seven vertebrae and the discs that serve as the cushion between them. Though the cervical spine naturally enables a wide range of motion, sometimes, surgery is needed to limit that motion in certain segments. Cervical fusion is a surgical technique in which the vertebrae in the upper portion of the spine are joined together so as to prevent motion. It helps eliminate symptoms of some disorders of the cervical spine, but as with any surgery, there are risks.
Reasons for Cervical Fusion
Cervical spinal fusions are used to remedy a variety of spinal ailments, including vertebral fractures; spinal deformity such as severe scoliosis; spondylolysthesis, where one vertebra slips forward on another; and vertebral instability, explains the North American Spine Society. Also, persistently symptomatic cervical disc problems that don't respond to conservative treatment are sometimes treated by fusion surgery.
Method
The goal of cervical fusion surgery is to form a solid union between adjacent vertebrae and eliminate instability. Usually, bone is taken from another location on the patient, or in some cases, from a bone bank, and used to fuse the vertebrae together, along with metal hardware to help hold the bone in place. According to the North American Spine Society, the most common surgical approach for a cervical fusion is anterior, or from the front, but occasionally, a posterior approach may be used.
General Risks
Cervical fusion procedures come with all the same risks of any surgery. The University of Maryland Spine Center states that complications from anesthesia, such as difficulty swallowing and allergic reactions to the drugs used; thrombophlebitis, or blood clots; lung problems; and infection are the general risks of cervical fusion surgery.
Implant Failure
Metal implants such as screws and plates are commonly used in cervical fusion surgeries. Sometimes, these implants can break, loosen or migrate, explains the American Academy of Orthopaedic Surgeons. Implants that move too much or break may put the patient at risk for injuring nearby structures, such as the spinal cord, and will often a second surgery.
Spinal Cord Injury
Because of the location of the surgery, cervical fusions run the risk of causing secondary injury to the spinal cord during the actual procedure. According to the University of Maryland Spine Center, damage to the spinal cord could cause serious nerve damage and lead to paralysis of some parts of the body.
Transitional Syndrome
When a cervical fusion is performed, it strengthens the bond of the affected vertebrae but it also restricts motion. Since the spinal column works as an entire unit, this can lead to the vertebrae above and below the surgery taking on more stress and load, suggests the University of Maryland Spine Center. Over time, this wear and tear can lead to pain in those areas.
Pseudoarthrosis
"Pseudoarthosis" means "false joint," and is the term used to describe a surgical fusion that still allows motion between the fused vertebrae When this occurs, pain can result, and the stress of the metal hardware leads to even more pain. A pseudoarthrosis often requires a follow-up surgery to add another bone graft, more metal implants or even an electrical stimulator to help the fusion heal, explains the University of Maryland Spine Center.
