There are two types of cervical fusion procedures: anterior cervical fusion, and posterior cervical fusion. In the anterior cervical fusion, the operation is done from the front of your neck. In the posterior cervical fusion, the operation is done through an incision in the back of your neck.
Most neck problems are from a degenerative, or aging, condition of the spine. Degenerative disc disease and cervical stenosis are two diagnoses that can lead to pressure on the spinal cord or nerve roots. Surgery to remove this pressure can be done from the front (anterior) or back (posterior) of the neck. Doctors use the anterior approach more often because the pressure is usually on the front portion of your nerves or spinal cord.
Anterior Cervical Fusion
Anterior cervical discectomy is one of the most common surgical procedures for problems in the cervical spine. The term discectomy means to “remove the disc.” This procedure is routinely used to relieve pressure on a spinal nerve or the spinal cord cause by a herniated disc. Discectomy is also done when your doctor intends to fuse two or more bones of your neck together. This procedure of disc removal and fusion (described below) is often used to treat degenerative problems (called spondylosis) in the neck.
In your cervical spine, the disc is usually removed from the front. An incision is made in the front of your neck beside your trachea (windpipe). The muscles are moved to the side. The arteries and nerves in your neck are also protected. Upon reaching the front of your spine, your doctor will use an X-ray to identify the problem disc. This disc is removed all the way back to your spinal cord. If any bone spurs are found sticking off the back of the vertebrae and your doctor thinks they may also be causing you pain, they may be removed at the time of surgery. Great care is taken to not damage your spinal cord and nerve roots.
After the disc between your vertebrae has been removed, a cervical fusion is performed. The space where the disc was taken out is filled with a block of bone graft taken from the top rim of your pelvis at the time of surgery. Bone graft taken from your own body is called autograft. Your doctor may obtain bone from a source other than your body, called allograft. This is bone that is taken from organ donors and stored under sterile conditions until needed for operations such as spinal fusion. The bone goes through a rigorous testing procedure, similar to a blood transfusion, before being used for fusion surgery.
Placing a bone graft between two or more vertebrae causes the vertebrae to fuse or grow together, creating a solid piece of bone. This halts motion between the problem vertebrae, creating stability in the joint. Cervical fusion is used to treat cervical fractures, dislocations, and other pathologies. It is also used to correct deformities in your neck.
The anterior cervical fusion may also be done in a way that spreads your vertebrae apart a bit to help restore the space between them. This is done to recreate the normal height of the disc space and to restore the normal inward curve of your neck (called lordosis). Increasing the distance between the vertebrae also widens the opening (foramina) where the nerves come out of your spine. Restoring the size of the foramina is done to relieve pressure and irritation from bone spurs where the nerves pass through the foramina.
Posterior Cervical Fusion
Posterior cervical fusion is done through the back of your neck. A bone graft is placed on the back surface of the problem vertebrae. During the healing process, the vertebrae grow together creating a solid piece of bone. This type of fusion is used in the cervical spine for fractures and dislocations. It is also used to correct deformities in your neck.