The seven bones in the neck are called cervical vertebrae, which form the upper part of the spine. Together they are called the cervical spine, and they protect the upper part of the spinal cord and its nerve roots.
Anatomy Of The Neck
Between the bones of the cervical spine are fibrous discs, which help prevent the bones from rubbing against each other. Sometimes, the cervical discs bulge out (herniate), causing nerve roots to be compressed. This condition leads to symptoms such as pain, numbness and tingling, as well as weakness in the arm and shoulder.
Neck or cervical spine surgery is usually performed to treat nerve or spinal cord impingement (also called decompression surgery) and spinal instability (called fusion surgery). An anterior cervical discectomy and fusion (ACDF surgery) may be done from the front of the neck to remove a herniated disc to relieve spinal cord or nerve root pressure. A small plate can also be used to reconstruct the spine to help add stability to the neck. While this procedure is most commonly used to treat a cervical disc herniation, it may also be done for diseases involving degenerative discs.
To promote postoperative healing, the spine surgeon may advise the use of a cervical collar for a short period of time. A cervical collar assists in healing and helps avoid extreme neck motion. The surgeon also provides instructions regarding activity restrictions in the post-op period. The use of external bone stimulators may be recommended to aid bone fusion for patients who may have a high risk of poor fusion. Patients may also be advised to avoid using non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief because they may inhibit bone formation and fusion. Smoking, which is also recognized as a risk factor for failure of fusion, must be avoided. In most instances, proper healing or fusion occurs in three to six months. Sequential x-rays may be required over time to monitor adequate healing and appropriate alignment at the surgical site.
Anterior Cervical Discectomy And Fusion Complications
These may vary according to the patient's age and general health condition, the extent of disc involvement, the surgeon's technical skills, and other factors.
These complications may include:
- Inadequate relief of pain and other symptoms after the surgery
- Temporary hoarseness
- Damage to the nerve root, causing pain, tingling, numbness and weakness to the arm
- Damage to the spinal cord, causing loss of bowel/bladder function and impaired sexual function
- Damage to surrounding structures such as the trachea, esophagus, or major blood vessels
- Non-union due to failure of bone graft healing
- Persistent speech or swallowing disturbance
- Leaking of cerebrospinal fluid
- Recurrent disc herniation
- Mechanical complications from the graft (such as graft migration) and plate (like screw pullout and breakage of the plate)
Before undergoing surgery, it is important to talk to your doctor about your symptoms and to get an accurate diagnosis. You must also be aware of the possible risks and complications of neck surgery, as well as your options of treatment.
In the post-operative period, it is necessary to get adequate monitoring of your healing process. Seek immediate consultation for complications that may arise after surgery.
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