As we age, degenerative changes in the discs, bones, and ligaments of our spine can cause a narrowing of the canal that the spinal cord runs through, affecting the cervical vertebrae and soft tissues. Sometimes, this narrowing of the spinal canal, also called spinal stenosis, is present from birth (congenital). Spinal stenosis can lead to spinal cord compression that can cause a varying degree of symptoms. Symptoms caused by pressure on the cervical spinal cord include difficulty with balance and walking, decreased fine motor function of the hands, numbness or weakness of the hands or arms, and neck pain. Spinal stenosis is a progressive disease that can continue to worsen with time.
One surgical procedure performed by Dr. Michael Wheeler, who performs orthopaedic spine surgery in Dallas, that treats cervical stenosis is a posterior cervical decompression and fusion. Decompression in this setting means relieving the pressure on the affected spinal cord or nerves. Posterior cervical fusion is an alternative to anterior cervical surgery in providing multiple-level stabilization of the bones of the spine from the back of the neck, often involving the use of a neck brace or soft cervical collar during postoperative care.
Benefits of Posterior Cervical Decompression and Fusion
Relief of symptoms caused by cervical spinal stenosis
Posterior cervical fusion allows for direct decompression of the spinal cord and nerves that are being compressed by a diseased disc, bone, or ligament, including conditions such as a herniated disc or cervical spondylosis. By removing the pressure off the cord and/or nerves in the cervical region of the spinal column, the symptoms the patient is experiencing should improve, providing relief from nerve injury and other spinal conditions.
Pain relief
By relieving the pressure off the spinal cord and affected nerve roots, chronic pain caused by the stenosis should be partially or completely relieved, which is a potential benefit of posterior cervical fusion. By relieving the pressure off the spinal cord and stabilizing the bones through the use of instrumentation such as screws and rods, quality of life can be drastically improved while minimizing potential risks associated with spinal fractures and trauma.
Correction of posture or poor alignment
As we age, degenerative changes of the spine can lead to abnormal curvature of the spine. This is usually seen in the form of kyphosis, which may be evaluated with X-rays to assess the extent of the deformity. Posterior cervical fusion done by a spine specialist under general anesthesia can help realign the spine and restore cervical lordosis (the proper curvature of the cervical spine). This will improve the patient’s posture and provide immediate stability, allowing them to stand up straighter and relieve stress on the neck and shoulders.
Patients Who Would Benefit From Posterior Cervical Decompression and Fusion
Cervical Spinal Stenosis
Patients with narrowing of the spinal canal in the neck that causes symptoms affecting daily life.
Cervical Myelopathy
Patients with spinal cord compression causing difficulty walking, hand coordination issues, numbness, or weakness.
Neck and Arm Symptoms
Patients experiencing neck pain, arm weakness, numbness, or reduced fine motor function.
Progressive Neurologic Symptoms
Patients with worsening balance, coordination, or functional limitations due to spinal cord compression.
Failed Prior Cervical Fusion
Patients who have had previous anterior cervical surgery with persistent symptoms or failure of fusion.
Persistent Spinal Stenosis
Patients with ongoing spinal cord compression despite prior treatment or surgery.
Surgical Procedure
For posterior cervical spine fusion, the spine doctor places the patient in a prone position (or face-down) on the operating table with lots of padding to protect the face and other bony areas.
Advanced monitoring of the nerves and spinal cord is used throughout the entire posterior cervical surgery allowing for safe monitoring of each spinal nerve and its function. This monitoring technique is called intra-operative neuromonitoring and is used for the patient’s safety.
The orthopedic spine surgeon will make an incision on the back of the neck over the affected level(s), providing access through the lamina. After the vertebrae (bones) have been exposed, lateral mass screws and rods are carefully placed for stabilization. If necessary, the spine surgeon will remove bone spurs or spinous processes to allow posterior decompression (to relieve pressure) of the spinal cord and/or nerves.
Bone graft material is then placed to help promote fusion of the bones and facet joints. The bone graft is usually a combination of the patient’s own bone and bone from a cadaver.
The spine doctor closes the small incision area using an absorbable suture, and places a dressing, while postoperative care includes keeping the surgical wound clean and dry, and patients are advised to follow treatment options including physical therapy.
Postoperative Period
The recovery time for posterior cervical fusion surgery varies widely, but it can take 3-6 months after surgery to feel fully recovered. The healing process involves a combination of pain medication, rest, and physical therapy, which helps relieve pain and aid in recovery. Avoiding bed rest, excessive bending, heavy lifting, and other activities that put extra stress on the back after spinal surgery is crucial. Although there will be some limitations to activity for most patients, staying mobile is key to a healthy recovery.
Risks and Possible Complications of Posterior Cervical Fusion Surgery
Schedule Your Appointment with a Dallas Posterior Cervical Fusion Surgeon Today!
If you’re trying to decide whether surgery makes sense — or just want to understand what recovery would look like for your specific situation, including how soon you might return to normal activities — that’s exactly the kind of conversation we’d have in consultation, where we also discuss conservative treatments, cervical disc replacement when appropriate, and postoperative care tailored to protect your neck during recovery.
