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Cervical Spinal Fusion

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Cervical spine fusion is usually done in conjunction with an anterior cervical discectomy. The anterior cervical discectomy is often done to remove a herniated or ruptured disc and with the use of a cervical spine fusion, a bone is graft to this now empty area (removed disc) to allow height to be maintained. A cervical spinal fusion can also be preformed to limit the motion of segments that are causing the patient pain. With some patients cervical spine fusion surgery may be require as stability for deformities or possibly fractures.

Reasons for having cervical spine fusion:

• In conjunction with anterior cervical discectomy
• Limit painful motions
• Trauma such as fractures or dislocations
• Infection
• Tumor

A bone graft that is usually harvested from the patient’s hip is used as a bridge to promote the growing together of two bones into one. A spinal fusion is performed to create a continuous bone surface with the end goal being eliminated motion at the fused joint.

Two types of bone for cervical spine fusion

Autograft
When a patient’s own bone is used for a spinal fusion it is called an autograft. Considered the standard since the 1950’s, the bone graft is harvested from the patient’s hip. The success rate for autograft bone fusing is usually 90-95%

One of the downfalls to the autograft bone is that during the surgery a second incision is required to harvest the bone from the patient’s hip. There are complications that can arise when the bone graft is taken, including:

• Infection can occur
• Extra bleeding to deal with
• The sensory nerve in the front of the thigh (Lateral femoral cutaneous) can be damaged during this harvesting
• Possible fracture to the pelvic bone

If the Patient is overweight and depending on the size of the bone graft, the chances for complication through the bone graft may increase. Even though this cervical spinal fusion is painful, the autograft is most often considered much more painful.

Allograft
The allograft procedure takes the procedure of harvesting the patient’s own bone out of the spinal fusion process by using a bone bank, or a bone donor instead of harvesting the patient’s bone. Because there are no living cells in the bone transplant, unlike living organs there is very little chance of rejection. Allograft has a higher instance of failure when compared to autograft.

An allograft heals slower than an autograft bone fusion. Some additional information:

• The success rate of fusion between allograft and autograft are nearly identical in one level spine fusion surgery
• To help the success rate of allograft spinal fusion, screws and plates are often used to add stability
• The success rate with fusion between allograft and autograft become more significant with the more levels that are grafted

The risks and complications attributed to cervical spinal fusion surgery:

• The main risk when talking about spinal fusion surgery is the bone graft not healing. Autograft and allograft when combined with anterior spine surgery will often yield good results
• If the spine surgeon chooses not to use plates or screws to attach the bone graft there is a small chance that the graft may become dislodged. If this happens a second surgery is required so that the graft can be reinserted