Cervical Fusion

Two days before your surgery, take a gentle laxative, such as colace or senna. This will help make sure your bowels are open the day you have surgery.

On the day you are scheduled for surgery it is important that you have nothing to eat. Do not eat anything after midnight on the night before surgery. Doctors and hospitals vary on how long prior to surgery you need to stop drinking water. You will be given pre-operative instructions that explain this. If you don’t understand something, be sure to ask your doctor.

All of your medications will be supplied by the hospital while you are a patient, so you do not need to take your medicines to the hospital. Make a list of all your medications and the doses prescribed to take with you to the hospital.

If you have had any scans or tests, take those results to the hospital with you also.

How it’s Done

If the fusion is completed from the front of the neck (anterior cervical fusion), one or more discs are removed, and a bone graft or an artificial disc is inserted to take its place. This helps to maintain the correct height and bone will then grow across space. A small plate is usually attached to the front of the spine to keep everything in alignment until the bone is healed.

If the fusion is completed from the back of the neck (posterior), the large muscles that lie on top of the vertebrae need to be moved to the side. In this procedure, screws are usually placed into the bones, and plates or rods are used to hold the bones together. A bone graft is placed alongside the bones which fuse the vertebrae together. A posterior cervical fusion typically is more painful than an anterior approach.

Post-Operative Care

You will wake up from surgery in a recovery unit, known as a post-anesthesia care unit or the PACU, in some hospitals. The staff there will make sure your condition is stable before transferring you back to your room.

Your physician may order a Patient Controlled Analgesia (PCA) pump for you to use to control your pain. The pump is connected to your IV (intravenous) line. When you are having pain, you can give yourself a dose of pain medication through your IV by pressing a button. These pumps have a lockout feature that prevents you from getting too much medicine. PCA pumps are an effective way for patients to control post-operative pain.

Following surgery, the physical therapy team will begin working with you. You will learn how to get safely in and out of bed and with their help, you will begin walking. The first few times you are out of bed you may feel dizzy or lightheaded. This is normal and will go away as you regain your strength. Your physician may order a collar for you to help support your neck. The therapist will help with the fitting of this, and your doctor will provide you with instructions about when and for how long the collar will be required.

The nursing staff will care for your surgical incisions, re-dressing them as needed. They will also provide you with all the information and instructions you need before your discharge from the hospital.

Home Care

You may be given a cervical collar to wear. Wear this as your doctor has instructed you.

It is very important to your recovery that you give your body time to rest and heal for the first 6 to 8 weeks following your surgery. Do not exercise or do any lifting during this time. You may be up and walking around while wearing the collar, according to your doctor’s instructions, but take things easy. Instead of taking one long walk, try taking several shorter walks.

• You can ride in a car as a passenger, but you will not be allowed to drive for at least six weeks. When you are riding as a passenger, be sure to make frequent stops to change position.
• Flying is usually not a problem, but some of the circumstances that accompany flying can be. Do not carry luggage or try to retrieve it off the carousel. Avoid standing or sitting for extended periods. Move around as much as you can. Check with the airline prior to your flight to see what accommodations are available.

When you can return to work is something you will need to discuss with your doctor. A big part of this decision is based on what type of work you do. A person whose day is spent at a computer may be able to return to their job sooner than someone who works in the construction industry. People who work in manual jobs may not be able to return to work until x-rays show the fusion is solid.

The nurses will instruct you on how to care for your incision before you are discharged from the hospital. If you have any questions, notify your surgeon or the hospital. Typically, new dressings are applied daily until the incision is no longer draining. Once the incision is dry and no drainage is seen on the dressings, the incision can be left open to air.

Pain medications can cause constipation, so be sure to drink lots of water and eat plenty of fresh fruits and vegetables or other foods to keep your bowels moving.

Rehabilitation

Usually around six weeks after surgery, if there have been no complications and your follow-up x-rays show healing, you will start physical therapy. Therapy will start with gentle exercises and gradually increase, so that by three months after your operation you will be cycling, swimming or at the gym on a regular basis.

Typically, patients are seen by their surgeons six weeks after surgery and then every three months for a year. X-rays are taken at every visit to monitor healing. If metal screws were used during surgery they can be removed in a few years, but this is not usually necessary.