Orthopaedic Spine Center
450 Broadway St. | MC6342
Redwood City, CA 94063
For Adult Patients: (650) 725-5905

Cervical Spine Surgery:
Posterior Cervical Fusion

Below are some of the procedures offered by Dr. Cheng to treat cervical spine conditions. Click the links below to learn more about the selected treatment:

Posterior Cervical Fusion is an operation to stabilize the spine, relieve pressure on irritated nerves and ensure this pressure does not return at that place. This surgery involves a small incision on the midline of the neck (posterior). The doctor will try to protect the nerve roots and safely remove the bone spurs, cysts, or other material pressing on the nerve. Next, bone graft is placed along the back of the spine, allowing the two vertebrae to grow together as one (fusion) over some months after surgery. After the operation, the area must be kept somewhat immobile to ensure the fusion grows. This may be accomplished by activity restriction, the wearing of a soft support brace, or a hard plastic brace. In some patients, metal screws and rods are placed in the spine to hold the bones while the fusion heals.

The purpose of this surgery is to stabilize the spine and relieve arm/neck, numbness, weakness, or lack of coordination and fine motor control caused by pressure on the nerves. The success rate of relieving arm pain is very high.

The surgery typically lasts two or more hours, depending on the number of discs operated upon, whether or not previous surgery has been performed, and the severity of pressure on the nerves. Blood loss can be dependent on the number of levels requiring surgery; if one or two level surgery is needed, blood loss can be minimal so usually no blood donations are necessary before the operation. Time spent in the hospital is short—most patients can go home two to four days after the surgery.

Risks of Surgery

Surgery and anesthesia involve stresses to many organs and tissues in the body. Incisions and handling tissues during surgery can result in many problems. The benefits of surgery must be carefully weighed against these risks. Some more common or serious problems are listed here.

Spinal Cord or Nerve Root Injury: Permanent injury to the spinal cord or nerve roots is extremely rare. It is not unusual, however to experience minor temporary tingling, numbness, weakness or pain which resolves over several weeks. All precautions will be taken but rarely, more serious nerve injuries may occur, effecting walking, balance, bowel or bladder functions.

Dural Tear: Leakage of spinal fluid can occur due to a tear in the tissue (called the “dura”) holding the spinal fluid and containing the nerves. On rare occasions additional surgery may be needed.

Infection: Infection is always a post-operative risk and occurs in approximately 1–2% of surgical patients, varying by surgery type. Infections may be superficial or deep into the bone. You are given antibiotics before and after the surgery to help prevent this complication. Please follow the instructions for wound care to help prevent infection.

Other complications: Other possible complications include blood clots, pneumonia and complications related to the general anesthesia.

Activities and Exercise / Rehabilitation

Adequate rehabilitation is crucial for a successful result. Many patients with spinal injuries have suffered from spinal pain for some time. This may result in considerable weakening of the spinal muscles due to lack of exercise, so you should return to your normal activities slowly.

The primary form of rehabilitation after surgery is an aggressive walking program. You should start immediately after discharge, walking more and more each day. In general, we recommend two to three episodes of exercise per day. The average patient can be walking 15 minutes twice a day by their first postoperative visit and 30–40 minutes twice a day by six weeks after surgery. Walk more if you are so inclined!

Expectations

Patients routinely experience a dramatic, remarkable reduction in their arm pain. If the nerve has been irritated for a long time, then a more gradual reduction of the arm pain is to be expected. As the nerve heals, expect tingling or a warm feeling. Depending on how long the symptoms have been present, strength is usually the second symptom to improve. Numbness in your arm / hand is the last to resolve and, if present for long enough prior to surgery, may be permanent. It is not uncommon to have an increase in neck pain from the surgery itself. This pain should subside over the following few weeks after surgery.