The spine is made up of several different discs, which are connected by joints between each and other material to cushion the spine. Over time, due to fracture or other degenerative condition, the spine can weaken and cause pain and discomfort when moving. When this occurs in the cervical spine (the first seven vertebra in the neck) and the pain begins to interfere with daily activities and movement, surgery to remove the diseased material and strengthen the joints in the neck may be recommended. This surgery is known as a cervical fusion.
How It Works
A cervical fusion procedure is actually two procedures in one: the first portion is a discectomy, which removes diseased material from the disc, which helps to take pressure off the nerves and reduce pain. Then, the fusion procedure is performed. This procedure involves placing a replacement piece of bone (taken from the pelvis or used as a graft from a bone bank) in the area where the disc previously was. This method causes two (or more, in cases of severe deterioration) vertebrae to fuse together and therefore strengthen the spine.
Voice Changes or Swallowing Difficulties
Because the operation is performed in the upper portions of the spine around the neck, in some cases, a surgeon can perforate the laryngeal nerve, which is connected to the vocal cords. This can cause hoarseness while speaking or even difficult in swallowing. While this complication is usually temporary, these difficulties may be permanent and require further therapies.
Bone Graft Migration
While surgical implants such as screws and plates are often used to hold the graft in place, it is possible for the bone graft to slip out of place. This is a more common occurrence when several vertebrae are fused together. Additional surgery may be necessary to secure the grafts if the migration causes intense pain or alterations to the spine.
Failed Fuse
Successful spinal fusion relies on the principle that the bones will grow together in order to strengthen the spine. In some instances, patients with risk factors, such as smoking, osteoporosis, obesity or malnutrition do not experience enough bone growth for the surgery to be a success. Smoking is particularly slowing to bone growth and should therefore be ceased following surgery.
Nerve Damage
In addition to damaging the vocal cords, it is possible to damage other nerves in the spinal cord, which can even result in paralysis. It also is possible that nerve damage will be permanent even prior to the surgery and that the fusion will not provide relief to the area. If this is the case, a surgeon can recommend treatments to relieve pain, such as spinal cord stimulation.
Tags: bone growth, diseased material, fusion procedure, spinal cord, strengthen spine, vocal cords, which connected