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Anterior Cervical Fusion


Why is this procedure done?


An anterior cervical fusion is a surgery to join two or more bones in the neck together so there is no movement. Anterior means that your doctor will do the surgery by making a cut in the front of your neck. It is used to treat long-term pain in the neck caused by: ‚  
  • Damage or injury to the discs or bones in the spine at the neck
  • Pressure on the nerves or spinal cord

Patients who have a spinal fusion have often tried other treatments such as drugs, rest, and physical therapy to ease their pain without success. ‚  


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What will the results be?


The goals of the surgery are: ‚  
  • To line up the spinal bones in the right place
  • Keep the space open where the nerves leave the spine
  • Prevent motion at the damaged joint

After surgery, you may have less pain or other signs. You may be able to move more easily too. ‚  

What happens before the procedure?


  • Your doctor will take your history. Talk to the doctor about:
    • All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
    • Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin, ibuprofen, Aleve (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
    • When you need to stop eating or drinking before your procedure.
  • Your doctor will do an exam and may order:
    • X-ray
    • MRI scan

What happens during the procedure?


  • Once you are in the operating room, the staff will put an I.V. in your arm to give you fluids and drugs. You will be given a drug to make you sleepy. It will also help you stay pain free during the surgery.
  • When you are asleep, the doctors put a tube in your mouth to help you breathe. You will have a tube in your bladder to drain urine.
  • Your doctor will make a cut on the front of your neck. Your doctor will carefully remove the disc and spread the spinal bones apart.
  • Bone from your hip or a bone substitute may be used to join or fuse the spine. Screws and plates may also be used.
  • A drain tube may be placed in your neck close to the cut site. This will get rid of any extra fluid or blood from around the cut site. The drain tube is hooked to a bulb. The bulb is emptied every day until the doctor removes the drain.
  • Your doctor will close the cut with staples, stitches, or glue. The whole procedure will take from 4 to 6 hours.

What happens after the procedure?


  • You will go to the Recovery Room after surgery. The staff will take out your breathing tube when you are awake and strong enough to breathe. You may have a sore throat afterwards.
  • You will have special neck brace that will need to be worn almost all the time. Ask your doctor how long you will need to wear this brace.
  • Your nurses and caregivers will roll you in bed from side to side every couple of hours after your surgery to prevent problems after your surgery, such as blood clots and pressure sores.
  • Your doctor may have you wear special stockings to prevent blood clots.
  • Sometimes you will get out of bed to a chair the same day of the surgery. The staff will help you begin to walk around.
  • Do coughing and deep breathing exercises to help keep your lungs clear.
  • Your doctor will give you drugs for pain relief. Take the pain pills or shots to help you to move better.
  • Your physical therapy will often start the day after surgery.
  • Most people will stay at the hospital for 1 to 2 days.

What care is needed at home?


  • Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not understand what the doctor says. This way you will know what you need to do.
  • Your doctor will teach you the proper way of moving to protect the spine.
  • Talk to your doctor about how to care for your cut site. Ask your doctor about:
    • When you should change your bandages
    • When you may take a bath or shower
    • If you need to be careful with lifting things over 10 pounds
    • When you may go back to your normal activities like work, driving, or sex
  • Be sure to wash your hands before touching your wound or dressing.
  • Wear your brace as instructed to by your doctor. If you are allowed to remove it for showering, avoid any twisting or sudden neck movements.
  • Ask your doctor when it is okay to begin taking drugs such as aspirin, Coumadin ‚ ®, and Plavix ‚ ® again.

What follow-up care is needed?


  • Your doctor may ask you to make visits to the office to check on your progress. Be sure to keep these visits.
  • If you have stitches or staples, you will need to have them taken out. Your doctor will often want to do this in 1 to 2 weeks.
  • You also may need to have more x-rays.
  • Your doctor may send you to physical therapy.

What lifestyle changes are needed?


  • Exercise your legs while in bed. This can help to prevent blood clots.
  • Practice good ways to lift things so that you do not hurt your spine. Your physical therapist will teach you better ways to move and lift.

What drugs may be needed?


The doctor may order drugs to: ‚  
  • Help with pain
  • Prevent infection
  • Prevent blood clots
  • Help with other problems you may have like trouble sleeping or hard stools

What problems could happen?


  • Pain
  • Bleeding
  • Infection
  • Incomplete fusion of the bones
  • Nerve or spinal cord damage
  • Damage to the sac covering the nerves (dural tear)
  • Problems with bowel or bladder function
  • Neck stiffness
  • Surgery does not help with pain and other problems

Where can I learn more?


American Academy of Orthopaedic Surgeons ‚  
http://orthoinfo.aaos.org/topic.cfm?topic=A00540 ‚  

Consumer Information Use and Disclaimer


This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚  

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