Posterior cervical decompression and fusion surgery removes the lamina, thickened ligament, and/or bone spurs that are putting pressure on the spinal cord and nerve roots. This compression is a result of a herniated or degenerated disc, spinal stenosis, and/or spinal instability. Nerve compression can lead to pain in the neck and arms, lack of coordination, and numbness or weakness in the arms.
Patient's head is held in a special gear called Mayfield head holder with 3 pins going into the skull. A midline incision is made in the back of the cervical spine. Muscles are pushed apart exposing the bone. Either bone spurs or discs are removed that are pinching the spinal cord or nerve root. For fusion bone is harvested from a separate incision over the posterior iliac crest and screws and rods are commonly used. Screws are not FDA approved. After surgery neck is placed into a neck collar for about 3 months.
Risks of the surgery include nerve injury, paralysis, bleeding, and wound infection. Fusion may not occur requiring further surgery at a later time. Hardware complications such as screw malpositioning with nerve root injury requiring reoperation may occur. At times symptoms may persist despite seemingly successful surgery for various reasons.
After surgery, a hospital stay is usually required. Complete recovery time may take between eight and twelve weeks. Although complications are rare, any surgical procedure carries risks. Possible risks include infection, bleeding, reactions to anesthesia, injury to the spinal cord, pain at the treated site, damage to nerves or arteries, blood clots and paralysis. These risks can be minimized by choosing an experienced surgeon to perform your procedure, and by adhering to your surgeon's instructions before and after your procedure.
Patients should not use any type of anti-inflammatory medications such as aspirin, Naprosyn, Vioxx, Celebrex as these medications can interfere with spinal fusion process.
Smoking is also discouraged as it can "melt away" the fusion.