The goal of spinal fusion is to stop the motion caused by segmental instability. This reduces the mechanical neck pain caused from excess motion in the spinal segment.
Anterior cervical fusions are done through an incision on the front of the neck. The incision length can be as short as an inch and a half but varies based on how many levels are being operated on and the size of your neck.
After making the incision Dr. Paul gently retracts the esophagus, trachea and blood vessels to gain access to the front of your spine. He then removes the disc and removes the disc, or bone. This is done in a manner to relieve pressure on the spinal cord and nerves.
Additional bone and ligament may be released to restore normal height and alignment to the disc space. This is done to improve the long term health of your spine and avoid future surgeries. A cage device sized for the needs of your spine is put into position. A plate and screws are applied at the end of the case to promote a fusion and allow early return to more normal activities.
Your implants are MRI compatible and are not known to set off metal detectors.
We have attempted to define the more common risks of surgery under each of the procedures outlined. It is impossible to outline all potential poor outcomes, but we have attempted to do so in good faith. It has not been formed as legal protection for us – only to better inform you. Please read them thoroughly.
Infections are a known complication of lumbar surgery. Infection rates are more associated with smoking, poorly controlled diabetes, obesity as well as other health factors. Less invasive and shorter procedures also have lower complication rates. Infections requiring additional surgery are extremely rare in Dr. Paul’s practice.
Bleeding can be a serious complication since blood accumulation can compress the spinal cord or nerve roots. For that reason we require discontinuing blood thinners, some anti-inflammatories and all herbal medications.
Spinal Leaks are a known complication in spine surgery but typically can be managed. They occur approximately 3 to 5% of the time They can be the result of adherent bone, disc, ligament or scar tissue to the dura and the membrane surrounding your nerves or spinal cord. They are far more associated with revision surgery, severe nerve compression and advanced age. If this occurs, we typically repair the leak during your operation. You may be required to lay flat for a short period of time afterwards. Late presenting or persisting spinal leaks can require additional surgery. Spinal leaks typically do not affect long term outcomes.
The average person does not notice a significant loss of motion from day to day. The exception would be people involved with significant overhead activities, such as tradespeople. People with pre-existing stiffness are more likely to notice a substantial loss of motion. Any loss is usually related to flexion and extension.
The rotational movement (often associated with driving) is less frequently affected since much of that motion comes from between the skull, first and second vertebral bodies.
What Will My Recovery Look Like?
It is not uncommon to feel mildly depressed or anxious for the first 4-6 weeks of surgery, but those feelings should go away as your daily activities and exercise resume. This is more common with larger or multilevel surgeries. If the depression continues, please consult with your primary care doctor.