Because of the weight the seven bones of the neck (cervical spine) have to support, chronic neck pain can be disruptive to your daily life. Even activities like driving, reading, and nodding your head may trigger pain. If your neck pain is due to a problem with one of the bones of your neck or a supporting disc, a regimen of conservative remedies is usually recommended. If these treatments aren’t providing significant relief, you may be a candidate for minimally invasive cervical fusion.
How Minimally Invasive Cervical Fusion is Performed
Cervical fusion is often performed after part or all of a damaged disc has been removed or bones in the neck (C1 to C7 vertebrae) have been surgically corrected. Small incisions about a 1-2 inches in length are made in the neck or back to access the affected area. The cervical spine is accessed without significantly altering surrounding muscles or soft tissues.
Bone graft material and/or implants are placed in the space left vacant by the removed disc. Hardware that includes rods and screws is also put into place to stabilize the cervical spine. The material used for the bone graft may come from other parts of the patient, such as the hips or ribs. An increasingly common option is to use synthetic graft material.
It typically takes several months for the bone graft material to solidify and develop to the point where the affected area of the neck is immobilized. With minimally invasive procedures, very specific parts of the cervical spine can be targeted. Doing so often minimizes how much flexibility of the neck is limited after the fusion forms.
Neck Conditions Treated with Minimally Invasive Cervical Fusion
Anytime the bones in the neck become unstable, fusion surgery becomes a possible option for restoring stability. There are several conditions that may cause parts of the cervical spine to become unstable. The most common cervical conditions that may result in a need for fusion surgery include:
- Herniated discs: Inner disc material protrudes outward and presses on nearby nerves; the resulting discomfort often extends to shoulders and arms.
- Slipped discs: Discs in the neck slip forward and onto the adjacent vertebra (cervical spondylolisthesis).
- Osteoarthritis: Bone-on-bone rubbing may contribute to neck pain and instability due to wear-and-tear (degeneration) from this form of arthritis.
- Bone spurs: Abnormal bony growths (osteophytes) on the cervical spine may narrow spaces within the neck to the point where nerves are affected. In some situations, vertebrae with bone spurs may need to be removed entirely.
Anterior Cervical Discectomy and Fusion
Anterior cervical discectomy and fusion (ACDF) is a specific minimally invasive procedure performed from the front (anterior) portion of the neck. The discectomy part of the surgery relieves pressure on either the cervical spine itself or nerve roots. A fusion is done at the same time if there is a need to restore stability within the affected area of the neck.
When Cervical Fusion is Recommended
Unless there is a pressing medical emergency involved, any type of surgery for chronic neck pain is often a last resort. It’s when the neck itself becomes unstable that cervical fusion is usually considered. Whether or not minimally invasive cervical fusion is suggested will depend on the extent of the instability. For instance, neck instability in multiple locations may be better treated with a traditional open procedure due to the potential difficulty with access.
Preferred Candidates for Minimally Invasive Cervical Fusion
Suitable candidates for minimally invasive cervical fusion have been diagnosed with a chronic condition affecting spongy discs in the neck or the structure of the cervical spine itself. The procedure may also be recommended for patients who haven’t had success with conservative treatments, including the use of over-the-counter and prescription medications, physical therapy, chiropractic manipulations, and the application of heat or ice. It’s also preferred that candidates are otherwise healthy without serious underlying medical conditions.
Recovery from minimally invasive cervical fusion often takes less time than what’s experienced with traditional fusion procedures. Because of the way such procedures are performed, patients often report less post-surgery discomfort. Further stability may be provided with temporary bracing following surgery to allow muscles and tissues to heal. Gentle neck stretches can also restore flexibility and range-of-motion as recovery progresses.