Cervical Discectomy with Fusion
Anterior cervical fusion is an operation performed
on the upper spine to relieve pressure on one or more
nerve roots, or on the spinal cord. The term is derived
from the words anterior (front), cervical (neck), and
fusion (joining the vertebrae with a bone graft).
When an intervertebral disc ruptures in the cervical
spine, it puts pressure on one or more nerve roots (often
called nerve root compression) or on the spinal cord,
causing pain and other symptoms in the neck, arms, and
even legs. In this operation, the surgeon reaches the
cervical spine through a small incision in the front
of the neck. After the muscles of the spine are spread,
the intervertebral disc is removed and a bone graft
is placed between the two vertebral bodies. Over time,
this bone graft will create a fusion between the vertebrae
it lies between.
In more than ninety percent of cervical spine fusion
surgeries done today a small cervical plate is used
to stabilise the spine immediately after surgery. This
hardware is used to improve the stability of the spine
immediately after surgery and to also decrease the chance
that the bone graft might be dislodged or moved slightly
from the position that it was placed in by the surgeon.
The use of hardware for stabilising the cervical spine
has changed the way in which cervical collars are used
after surgery. Today, collars are typically worn for
a shorter period of time after surgery than in the past.
Successful recovery from anterior cervical fusion requires
that you approach the operation and recovery period
with confidence based on a thorough understanding of
the process. Mr. D'Urso has the training and expertise
to correct physical defects by performing the operation;
he and the rest of the health care team will support
your recovery. Your body is able to heal the involved
muscle, nerve, and bone tissues. Full recovery, however,
will also depend on you having a strong, positive attitude,
setting small goals for improvement, and working steadily
to accomplish each goal.
Surgery for anterior cervical fusion is performed with
the patient lying on his or her back. A small incision
is made in the front of the neck, to one side.
After a retractor is used to pull aside fat and muscle,
the disc is exposed between the vertebrae. Part of it
is removed with a forceps.
Then a surgical drill is used to enlarge the disc space,
making it easier for the surgeon to empty the intervertebral
space fully and remove any bone spurs. Afterwards, only
a single ligament separates the surgical instruments
from the spinal cord and nerve roots.
biocompatible plastic (PEEK) cage filled with tricalcium
phosphate bone substitute in then placed into the space.
This is a new alternative Mr. D'Urso uses instead of
a traditional bone graft harvested from the iliac crest
(pelvis). This avoids a second incision and aids a faster
recovery. New bone grows through the cage to allow a
rapid fusion to the adjacent vertebrae to occur.
Placing a fusion cage between the two vertebral bodies
is done in order to create a fusion between these bones.
The fusion is a direct result of the fusion cage, but
small, specialised metal plates are also placed on the
front of the cervical spine in order to increase the
stability of the spine immediately after the operation.
Surgeons use cervical hardware to decrease the amount
of time that you will have to wear a collar after surgery,
and also to increase your chances of getting a solid
fusion between the two vertebral bodies. As the cage
is filled with a bone substitute material, this also
assists the fusion process.
The operation is completed when the neck incision is
closed in several layers. Unless dissolving suture material
is used, the skin sutures (stitches) or staples will
have to be removed after the incision has healed.
here to download a Patient Information Sheet on Cervical
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