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Cervical spine fusion surgery

C-spine surgery or spondylosyndesis is a procedure done to alleviate symptoms and manage pathology associated with the bony and nerve structures of the neck.

This procedure involves two main processes. Firstly, a surgeon uses cages, plates, screws or other stabilizing equipment to prevent movement between the vertebrae and, secondly, they will implant bone or bone-stimulating products to facilitate the normal healing process.

Conditions where spinal fusion is indicated include the following:

  • Spondylosis (degenerative disk disease).
  • Discogenic pain with associated referred pain involving a limb.
  • Spinal disk herniation with nerve impingement with or without spinal cord compression.
  • Spinal tumours.
  • Spondylolisthesis (vertebral instability).
  • Vertebral fractures.

Post-operative measures and the recovery process

C-spine surgery requires that the patient stay in hospital for a short period of around 3 days. This is to make sure that there aren't any complications that arise such as infection (sepsis) or blood clots in the wound (haematoma). Patients should be able to get up and walk around before being discharged from hospital.

There are some factors which will increase the hospital stay and would need to be managed. These include the following:

  • Obesity.
  • Smoking tobacco products.
  • Osteoporosis.
  • Diabetes.
  • Chronic steroid use.
  • Malnutrition.
  • Depression.
  • Chronic use of narcotic pain medication before surgery. The patient may undergo withdrawal symptoms here.
The recovery process is a gradual one and can take between 1-6 weeks. In patients who have had minimally invasive neck surgery, called endoscopic micro discectomy, the recovery process can be as short as 2 days. Patients are also advised to wear a neck brace or collar for up to 8 weeks after the procedure to make sure that there's proper spinal alignment.

Regarding the neck brace, it's important that it is worn as it also helps to make the patient aware that they shouldn't be making any sudden or excessive movements. It's also very important that the brace is worn when traveling in a car, sleeping, taking a shower or when performing any activities which require stability of the neck.

Pain is managed with pain killers which are prescribed by the surgeon. This will include narcotic medication which will be given for 4 weeks. Thereafter, the pain would have resolved to a point where this medication can then be stopped.

3 weeks after the procedure, the patient should be cleared to continue with light duties at home. Items weighing around 5 kilogram will also be permitted at this stage. It's important to remember to still take breaks in between and to rest if fatigue sets in.

Physiotherapy, massage therapy and acupuncture are healing modalities which are required to help aid in promoting appropriate healing, as well as to help in strengthening the surrounding neck muscles. This allows these muscles to take over the brace's function when its removed gradually around 4-6 weeks after the procedure. Therapy can continue up to 2-3 months after the operation. 

It's still possible to experience some numbness or weakness in the affected arm(s) even after 4 weeks following the operation. This should gradually get better over time. If the problem starts to worsen then you should consult with the surgeon as soon as possible.


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