Arthrodesis (also known as fusion) is when a surgeon joins two or more vertebrae into one segment of bone. This is done for conditions such as fractures, or to fix deformities in the spine such as spinal stenosis. When done in the back of the neck, it is known as posterior cervical fusion. While it has its benefits, it also has its own unique side-effect profile that must be considered by the patient before undergoing the surgery.
Anesthetic Complications
While the surgery carries its own risks, the anesthetic agent given to facilitate the surgery can also cause reactions with the patient, including include allergic reactions like anaphylaxis. These are usually quite rare, but always a risk that should be considered.
Blood Clots
Surgery is an independent risk factor for the formation of blood clots (deep-vein thrombosis, or DVT), especially in the veins of the leg. They can cause local symptoms like leg swelling and pain, or can dislodge and travel to the lung. In this case, they are known as pulmonary emboli and can be quite dangerous. There are many ways to prevent DVT that you can discuss with your surgeon. You can employ mechanical means such as pressure stockings, or medications that thin the blood and thus reduce the chances of clots forming.
Infection
Infection is a risk of any surgery where an incision is made, and posterior cervical fusion is no exception to the rule. Superficial infections of the skin where the incision is made are usually easily treatable, but if infection spreads to the deeper tissues and down to the spine itself, treatment can become very complicated, sometimes even necessitating further surgery.
Radiculopathy (nerve damage)
Injury to nerve structures is always a possibility when surgical work is being done near the spinal cord. Direct damage from surgical instruments, swelling around nerves from local inflammation and scar-tissue formation are all possible culprits for damage to nervous-system structures. These can manifest in many different ways, such as abnormalities with sensory perception and motor problems like weakness.
Graft Problems
Surgeons typically take a bone graft from another bone in the body, such as the hip bone, and use it to help keep the spine stable. Often this can shift after surgery, causing instability, which can cause damage to nearby tissue. Repeat surgery is often undertaken to correct this complication.
Pseudoarthrosis
This is also known as nonunion, and occurs when the bones do not fuse as intended by the surgeon. This can result in further joint motion that can cause pain and damage to nearby tissues. Repeat surgery is often done to correct this with further grafting or even insertion of metal plates and screws to rigidly secure the bones.
References
- "Campbell's Operative Orthopaedics, 11th Edition;" Canale & Beaty; 2007
- Posterior Cervical Decompression and Fusion by Dr Lali Sekhon
