Cervical fusion: indications and contraindications, methods of surgery
Cervical fusion is a surgical procedure that is a type of arthrodesis. The purpose of surgery is to immobilize one or more vertebral-motor segments. This is accomplished by installing special structures that hold the vertebrae together to fuse them securely. As a result, over time, they firmly merge, which completely eliminates the possibility of movement and the development of painful sensations in the background. Cervical fusion is necessary for many pathologies of the spine that are not amenable to conservative treatment. Therefore, it is often combined with other surgical procedures. Spine surgeons will help you get rid of your spine problems and perform fusion surgery.
Indications for cervical fusion
Spondylolisthesis and vertebral instability, which are accompanied by severe pain, require the elimination of movement of the vertebral-motor segment. The vertebral-motor segment is the structural and functional unit of the spinal column that consists of two adjacent vertebrae, the disc between them and the facet joint and its ligaments. Vertebral instability is most often caused by severe osteochondrosis, in which the intervertebral discs are severely damaged and completely lose their function. As a result, a large number of patients additionally experience not only intervertebral hernias, but also osteoarthritis of the facet joints and compression of the spinal cord and its nerve roots.
Each of these conditions is accompanied by severe pain, which in almost half of the cases cannot be treated conservatively. Therefore, in such cases, patients are assigned a surgical intervention appropriate to the situation, followed by cervical fusion. This can include:
- facetectomy, indicated for severe spondyloarthrosis;
- decompression of the dural sac, necessary for compression of the spinal cord;
- meningoradiculolysis, which is used when adhesions form in the root area of the spine.
Most often, patients undergo intervertebral hernia removal and the installation of special cage discs in place of the resected discs. Only such a comprehensive approach guarantees the complete elimination of the pain syndrome and the reliable prevention of its occurrence in connection with the injury of the same vertebral-motor segment in the future.
Indications for cervical fusion after release of compressed nerves and removal of severely damaged intervertebral discs are:
- vertebral dislocation (spondylolisthesis);
- osteoarthritis of the facet joints (bowed joints);
- scar epiduritis;
- congenital or acquired instability of the spine; severe kyphosis, 3-4 degree scoliosis;
- osteochondrosis accompanied by discogenic pain;
- regularly recurring radicular syndrome due to different causes;
- herniated discs that cause compression of the nerves or the spinal canal;
- neoplasms in the spine of any origin;
- spinal canal stenosis;
- spinal compression fractures derived from osteoporosis; F
- fractures, fractures and other injuries of the spine.
In each individual case, the spine surgeon selects the type of intervention to be performed on a strictly individual basis and develops a step-by-step plan for the course of the operation. To do this, you need the results of laboratory tests, MRIs, CT scans, or X-rays.
Cervical fusion of the cervical spine
Later cervical spondylosis with transpedicular fixation is most often performed for severe degenerative-dystrophic changes in the cervical vertebrae. If stabilization in one position is necessary, 1, 2 or more vertebral-motor segments can be stabilized. But this method requires a high level of professionalism on the part of the neurosurgeon, as it involves a risk of damage to nerve fibers and blood vessels.
If such complications are detected in the preoperative preparation stage, the installation of metal frameworks for fixation of the posterior support complex of the vertebral-motor segment is preferred. These allow fusion of the vertebral processes, resulting in a cervical fusion.
Cervical fusion can also be performed through an anterolateral approach. Severe trauma to the cervical spine is an indication for it. In such cases, the vertebral fixation method is chosen individually for each patient based on the results of the MRI. Highly effective surgical treatment for cervical spine fractures is characterized by intersomatic cervical spondylosis combined with highly effective anterior fixation plate placement.
As a result of surgical intervention, in most cases it is possible to achieve complete elimination of the pain syndrome, allowing patients to return to their daily activities. In some cases, occasional minor annoyances may occur, which do not affect the ability to work.
Characteristics of the rehabilitation.
Cervical fusion does not belong to the category of simple surgical procedures. The patient spends the first 24 hours in the intensive care room under constant medical supervision. If during this time, there are no signs of complications and positive dynamics are observed, the patient is transferred to a regular hospital ward and allowed to get up and walk a short distance without assistance.
The patient is discharged from the hospital at different times, which is determined by the type of surgery performed and the extent of the cervical fusion. In a medical center, for example touchofhealthmedical.com, the patient receives detailed instructions on the rules of behavior during rehabilitation, referrals to physiotherapeutic procedures and exercise classes.
To speed up the repair process, patients are prescribed individually selected medications and a brace.
On average, it takes 2 to 4 months for the body’s final recovery. During this time, heavy physical work, lifting weights and sitting for long periods of time are prohibited.
If all the recommendations received are followed precisely, patients return to a full life and do not suffer from mobility limitation, especially whenn perform a mono and bisegmental cervical fusion. Minor difficulties may arise only when several spinal motor segments fuse during flexion.
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