Anterior cervical fusion
What is anterior cervical fusion?
Cervical vertebrae fusion is a surgical technique that unites the bones present in the cervical spine. If performed by an anterior approach, it provides access to the spine from the front of the neck.
What is the purpose of anterior cervical fusion?
Anterior cervical fusion allows bones of the cervical spine to be joined with or without the insertion of implants (cage, plate-cage, and plaques), metal (titanium) and non-metallic objects. This connection is closely tied by a bone fusion, which can be taken from the iliac crest, or it can be of synthetic origin. During the same intervention, several vertebrae can be operated on.
What steps should be taken to help prepare for the surgery?
The patient should be at the hospital with the complete results from previous tests carried out and follow any instructions given by the doctor in regards to the routine for food and medication intake.
Which patients can undergo this surgery?
Anterior cervical fusion is performed in cases regarding trauma or deformation following trauma, tumors, infections, cervical spondylosis, cervical stenosis and degenerative deformities.
Is anterior cervical fusion painful and / or dangerous?
The discomfort and post-operative pain symptoms associated with the procedure by anterior approach are shorter than those associated with posterior approach. Possible complications include hoarseness or dysphagia, vascular damage (arterial) or visceral damage (organs within the chest/abdomen). Moreover, grafts can increase the risk of osteoarthritis.
What are the advantages to undergoing anterior cervical fusion?
The debate about which is the best approach to cervical fusion, either by anterior or posterior approach is still up for discussion. Data gathered from scientific literature show the effectiveness of both approaches and generally, the logical choice seems to proceed the location of the problem itself. The surgeon can, however, also base their analysis on other parameters, such as cervical instability. The advantages to the anterior approach include better control of spinal cord compression, which typically takes place in that compartment, originating from the disc, fewer hassles, and lesser post-operative pain. However, to proceed with the anterior approach also poses a risk to the blood vessels, viscera, and the recurrent laryngeal nerve.
Is hospitalization required?
The incision can be made horizontally or longitudinally on the right or left side of the neck. Later on, a simple discectomy is made, in fusion with a graft or with insertion of cage or plate-cage implants fastened with screws. The surgery is performed under general anesthesia while the patient lies in a supine position on the operating table, possibility with pillows below the knees. The use of electrodes may be necessary to monitor nerve activity, as well as a bladder catheter and other tools to help reduce the risk of deep venous thrombosis.
After surgery, monitoring the functional and neurological healing of the wound is necessary. Some doctors recommend the use of temporary external orthoses, such as collars.