Neck Fusion Surgery - Indication, Complications, and Prevention

Introduction

Cervical spine disease is a major health concern and is associated with socioeconomic burden. Spondylosis, trauma, tumors, and deformity are common problems of the neck. Surgical treatment options include non-fusion procedures (for example, decompression, arthroplasty, laminoplasty) and arthrodesis. For fusion, various surgical approaches (anterior, posterior, and circumferential) are available. Over the past two decades, the rate of cervical spinal fusion surgery has increased significantly. The affected number of people aged 65 years or older at 40.5 million, or 13 percent of the total US population, which is projected to double by 2050 estimated by the United States Census Bureau in 2010. Surgery is considered appropriate when the risks outweigh the advantages of the procedure. Complications are frequent in complex surgery performed on individuals older than 70 years, and on average 77 percent of patients improve in some way. Patients who require revision surgery or experience a surgical complication are more likely to experience slower healing. When managing spinal problems in senior people, knowledge about observed results, including risks and advantages of surgery, will enable educated decision-making. This article will discuss problems after neck fusion surgery.

What Is Neck Fusion Surgery?

Neck fusion surgery, also known as cervical fusion, is a procedure that is performed to alleviate neck pain and other symptoms caused by spinal disc degeneration, spinal stenosis, or other spinal conditions. Although this surgery is generally considered safe, there are potential complications that can occur, one of which is neck fusion problems after surgery.

Neck fusion surgery is performed in the following steps:

• Anesthesia: The patient will be placed under general anesthesia, which means they will be asleep and not feel any pain during the surgery.

• Incision: An incision is made in the front or back of the neck to access the cervical spine (nerve of the neck).

• Disc Removal: The surgeon will carefully remove the damaged disc material.

• Fusion: To stabilize the spine, the surgeon will use bone graft material to fill the space where the damaged disc was removed. The bone graft material may be taken from the patient's own body (autograft) or from a donor (allograft). The surgeon may also use metal plates, screws, or rods to hold the vertebrae in place while the bone graft material fuses together and creates a solid bone.

• Closure: Once the fusion is complete, the incision is closed using stitches or staples.

What Are the Indications for Neck Fusion Surgery?

The following are the indications for neck fusion surgery:

• Spondylolysis (a condition in which an age-related condition where the joints and cartilage-lined discs of the neck are affected).

• Spinal stenosis (a condition where the spinal column narrows and compresses the spinal cord).

• Fracture in the neck.

• Dislocation of the neck.

• Deformity of the neck.

• Degenerative disc disease in the spinal cord.

• Compression of the nerve of the neck.

• Myelopathy (a nervous system disorder that can permanently affect the spinal cord. It causes a loss of sensation, loss of function, and pain or discomfort).

• Spinal cord surgery.

Why Neck Fusion Surgery Is Performed?

Neck fusion surgery is typically considered when non-surgical treatments, such as physical therapy or medications, have been unsuccessful in relieving the patient's symptoms. However, it is important to note that not all patients are candidates for this procedure, and the decision to undergo neck fusion surgery should be made in consultation with a qualified medical professional. The procedure involves the use of bone graft material to help the vertebrae fuse together, creating a single, solid bone. In some cases, metal plates and screws may also be used to provide additional stability during the healing process.

The main reasons why neck fusion surgery is performed are:

• To Reduce Neck Pain: Neck fusion surgery can alleviate chronic neck pain caused by spinal conditions, such as degenerative disc disease, spinal stenosis, or herniated discs.

• To Improve Spinal Stability: If the vertebrae in the neck are unstable or moving too much, it can cause pain and other symptoms. Neck fusion surgery can help to stabilize the spine and reduce movement between the vertebrae.

• To Relieve Pressure on Nerves: If a spinal condition is compressing a nerve in the neck, it can cause pain, numbness, or weakness in the arms or hands. Neck fusion surgery can help to alleviate this pressure and improve nerve function.

What Are the Complications of Neck Fusion Surgery?

There was an overall 4.3 % in-hospital complication rate after fusion surgery.

The following are the complications of neck fusion surgery:

• Dural tear.

• Major bleeding.

• Postoperative (after surgery) infection.

• Respiratory complications such as sepsis, septicemia, and shock.

• Dysphagia (difficulty in swallowing).

What Are Neck Fusion Problems After Surgery?

Neck fusion problems can manifest in several ways. Some of the most common issues include:

• Pain.

• Stiffness.

• Restricted movement in the neck.

• Patients may also experience difficulty swallowing.

• Numbness or tingling in the arms or hands.

• Weakness in the muscles. In some cases, neck fusion problems can result in the need for additional surgery to correct the issue. One of the main reasons that neck fusion problems occur is because of the use of metal plates and screws to stabilize the spinal vertebrae. While these devices are necessary to hold the vertebrae in place during the healing process, they can also cause complications. For example, the metal plates and screws can loosen over time, which can cause pain and movement restrictions.

• There are other potential complications that can arise after neck fusion surgery. For example, patients may experience an infection at the surgical site, which can be serious if not treated promptly.

• There is also a risk of nerve damage during the surgery, which can cause numbness or weakness in the arms or hands.

How to Prevent Neck Fusion Problems?

To minimize the risk of neck fusion problems, it is important for patients to carefully follow their surgeon's post-operative instructions. This may include wearing a cervical collar to help support the neck during the healing process and avoiding certain activities that could put stress on the neck. Patients should also keep their surgical incision clean and dry, and report any signs of infection or other complications to their surgeon right away.

Conclusion

Neck fusion problems can occur after surgery, and patients should be aware of the potential risks and complications associated with this procedure. While most patients do not experience any significant problems, it is important to follow post-operative instructions carefully and report any issues to the surgeon promptly. With proper care and attention, most patients can recover successfully from neck fusion surgery and enjoy a better quality of life.