Cervical Spinal Fusion

Surgery Overview

Cervical spinal fusion (arthrodesis) is a surgery that joins selected bones in the neck (cervical spine). There are different methods of doing a cervical spinal fusion:

  • Bone can be taken from elsewhere in your body or obtained from a bone bank (a bone graft). The bone is used to make a bridge between vertebrae that are next to each other (adjacent). This bone graft stimulates the growth of new bone. Man-made (artificial) fusion materials may also be used.
  • Metal implants can be used to hold the vertebrae together until new bone grows between them.
  • Metal plates can be screwed into the bone, joining adjacent vertebrae.
  • An entire vertebra can be removed, and the spine then fused.
  • A spinal disc can be removed and the adjacent vertebrae fused.

This procedure can be done through an incision on the front (anterior) or back (posterior) of the neck.

What To Expect

This surgery usually requires a short stay in the hospital. You may need to wear a brace on your neck (cervical collar) during recovery.

Why It Is Done

Cervical spinal fusion may be done:

  • After an injury, to stabilize the neck and prevent a bone fracture from causing instability or damage to the spinal cord, which may result in paralysis.
  • To treat conditions such as misalignment of the vertebrae.
  • As a follow-up procedure to treat spinal stenosis, a herniated disc, the effects of rheumatoid arthritis, an infection, tumors, or spinal deformities.

How Well It Works

Often spinal fusion is needed to keep the spine stable after injury, infection, or a tumor.

When symptoms such as numbness or weakness in the arm suggest that a neck problem is causing a pinched nerve (radiculopathy), surgery may help you feel better faster. But it's not clear that surgery is any better than nonsurgical treatment in the long run. And research also suggests that a complex surgery that includes fusion is not better than a simpler surgery to take the pressure off the nerve.footnote 1

If you have neck pain alone, with no signs of a pinched nerve, neck surgery will not help.footnote 1

Risks

Although cervical spinal fusion stiffens part of the neck, this does not reduce neck flexibility for most people.

Surgery and the use of anesthesia involve some risk. The risks associated with this procedure vary depending on your age and overall health, diagnosis, and type of procedure used. Risks include:

  • Pain in a bone graft site (donor site).
  • Failure of the fusion, breakage of metal implants (if used), or both.
  • Blood clots in deep veins.
  • Nerve or spinal cord injury.
  • Graft rejection.
  • Infection.
  • Excessive bleeding.
  • Risks of general anesthesia.

What To Think About

Because there are so many things to consider when spinal fusion is recommended, seek a second opinion before making a decision.

References

Citations

  1. Carragee EJ, et al. (2008). Treatment of neck pain. Injections and surgical interventions: Results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Spine, 33(4S): S153-S169.

Credits

ByHealthwise Staff
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Adam Husney, MD - Family Medicine
Kathleen Romito, MD - Family Medicine
Robert B. Keller, MD - Orthopedics

Current as ofNovember 29, 2017