Posterior Cervical Fusion
Posterior cervical fusion is a form of surgery that uses material called a bone graft to join or fuse at least two of the bones in your neck (cervical spine) together. While some fusion surgeries require the surgeon to approach these bones from the front of the neck, posterior cervical fusion requires an approach from the rear of the neck.
Posterior Cervical Fusion Basics
At the start of a posterior cervical fusion, your surgeon will make an incision in the center of the back of your neck; the precise length of this cut will vary according to the number of spinal bones (vertebrae) that need to be fused together. He will then expose the targeted vertebrae by working his way through your muscle and other tissues while causing as little damage as possible. Next, he will create a smooth surface for the rest of the procedure by shaving back the raised segment on the rear of each bone, called the spinous process, as well as the spinal joints called facet joints.
After preparing the vertebrae in this manner, your surgeon will take bone that’s been harvested from your hip, or from a medically preserved human cadaver, and lay it vertically across the gaps between the targeted bones. Once the pieces of bone are in place, he will secure them with stainless steel wire, or with metal rods or plates held in place by screws. In addition to the material used to hold the bone graft itself in position, some surgeons physically connect the vertebrae on both sides of the graft with metal rods and screws. Over time, the grafted bone will fuse with the vertebrae and create a longer structure that functions like a single, extended bone.
Posterior Cervical Fusion Uses and Benefits
Posterior cervical fusion is typically used on people who have fractures in their cervical vertebrae, have dislocated cervical vertebrae, have mechanically unstable cervical vertebrae that degrade normal neck function, or have spinal deformities that seriously alter their normal neck curvature. If you have pain related to these problems, the procedure can lead to significant decreases in your long-term symptoms. If you have neck instability that threatens the integrity of your spinal cord, posterior cervical spinal fusion can help protect the long-term health of this vitally important structure. People who already have spinal cord damage may undergo the procedure to speed their recovery process and allow participation in an appropriate rehabilitation program.
Posterior Cervical Fusion Risks
The risks associated with posterior cervical fusion are essentially the same as the potential complications associated with other forms of major spinal surgery. They include bad reactions to general anesthesia, failure to correct your original problems, uncontrolled bleeding, chronic pain, damage to your spinal cord or spinal nerves, infections, damaging stress on the vertebrae above and below the site of the procedure, blood clots in the legs that can threaten your life if they migrate to your lungs, pneumonia, paralysis and death. The hardware used to fix your bone graft in place can also fail and allow unwanted movement in your healing bone. Additionally, people who undergo posterior cervical spinal fusion have significantly higher complication risks than people who undergo a fusion procedure performed from the front of the neck.
University of Southern California – USC Center for Spinal Surgery: Posterior Cervical Fusion
University of Maryland Medical Center: A Patient’s Guide to Posterior Cervical Fusion
University of Maryland Medical Center: A Patient’s Guide to Complications of Spinal Surgery
U.S. Department of Health and Human Services – Agency for Healthcare Research and Quality: Outcomes/Effectiveness Research – Primary Anterior Cervical Fusion Has Lower In-Hospital Complication Rates and Deaths Than Posterior Cervical Fusion