Posterior cervical fusion is a surgical procedure used to permanently stabilize the spine by joining the bones together. It is commonly used for multilevel spinal cord compression (cervical myelopathy) in combination with decompression and instrumentation.
Quick Facts:
- Performed through the back of the neck
- Stabilizes the spine with instrumentation and fusion
- Commonly combined with decompression surgery for multi-level spinal cord compression
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WHAT IS POSTERIOR CERVICAL FUSION?
This procedure involves two key components:
Posterior instrumentation
- Placing screws and rods in the back of the spine for short and medium term stability
- For more information, review this link for screw and rod instrumentation
Fusion
- The back of the spine is drilled to simulate a spine fracture
- Bone graft is used (your own bone and sometimes donor bone / proteins) to fuse the spine
👉 The goal is to permanently join the spine together
WHAT CONDITIONS DOES IT TREAT?
This procedure is commonly used for:
- Cervical myelopathy
- Cervical fractures
- Cervical deformity
- Degenerative changes affecting multiple levels
- Multilevel spinal stenosis
- Spinal cord compression
👉 It is especially useful when compression spans multiple levels
SYMPTOMS THAT MAY REQUIRE THIS SURGERY
Common Symptoms
- Difficulty walking
- Balance problems
- Hand clumsiness
- Weakness
Additional Symptoms
- Numbness or tingling
- Neck pain
🚨 When Surgery May Be More Urgent
- Progressive myelopathy
- Worsening gait or coordination
- Declining hand function
👉 These are signs of spinal cord compression requiring prompt evaluation
HOW IS THE PROCEDURE PERFORMED?
Step-by-Step Overview
- Anesthesia
- Performed under general anesthesia
- Posterior Approach
- Incision in the back of the neck
- Decompression
- Removal of bone to decompress the spinal cord
- Instrumentation
- Placement of screws and rods
- Fusion
- Bone graft is placed to allow the spine to heal into a stable unit
👉 The procedure provides both decompression and long-term stability
OUR APPROACH
We focus on appropriate use of fusion surgery
- We carefully evaluate when fusion is necessary
- The number of levels treated is tailored to the patient
- We prioritize safe spinal cord decompression
- Bone quality and alignment are key considerations
👉 The goal is to relieve symptoms while maintaining long-term stability
WHAT TO EXPECT
Before Surgery
- MRI and alignment imaging
- Evaluation of spinal cord compression
- Surgical planning
Day of Surgery
- Performed under general anesthesia
- Procedure length depends on levels treated
After Surgery
- Hospital stay is common
- Gradual improvement in neurologic symptoms
- Recovery over weeks to months
OUTCOMES & RISKS
Potential Benefits
- Relief of spinal cord compression
- Improved walking and coordination
- Prevention of neurologic decline
- Stabilization of the spine
Risks
- Infection
- Bleeding
- Nerve or spinal cord injury
- Failure to fuse
- Hardware-related complications
- Reduced neck motion
👉 Outcomes depend on severity of myelopathy and timing of surgery
FREQUENTLY ASKED QUESTIONS
Why is fusion needed with this procedure?
Removing bone can create instability, so fusion provides support.
Will I lose motion in my neck?
Some motion is lost at treated levels, but overall function is usually preserved.
How does this compare to laminoplasty?
Laminoplasty preserves motion, while laminectomy with fusion provides more stability.
Will my symptoms improve?
Many patients improve, especially when treated before severe progression.
FOR REFERRING PHYSICIANS
- Refer patients with:
- Cervical myelopathy
- Multilevel stenosis
- Progressive neurologic symptoms
- Imaging:
- MRI cervical spine
- X-rays for alignment
- CT if needed for bony detail
- Urgent referral for:
- Progressive neurologic decline
- Gait instability
RELATED CONDITIONS / PROCEDURES
- Cervical Neurologic Symptoms
- Posterior Cervical Laminoplasty
- Anterior Cervical Corpectomy
- ACDF (Anterior Cervical Discectomy and Fusion)