Anterior Cervical Fusion - NEUROSURGERY（颈椎前路融合神经外科）.pdf

Anterior Cervical Fusion What is a Cervical Fusion ? This is when two or more vertebra are joined with bone fragments, when this sets it fuses. Why is this usually done ? Because you have: 1. A disc prolapse causing pressure on the spinal cord or a nerve root 2. A spur of bone (osteophyte) pushing on something. If you are having surgery at one level could you need to have another done to protect it ? Yes! What are the different ways this can be done.? 1. Removing the disc and replacing with bone from your iliac crest 2. Placing bone inside a cage and placing that inside the disc space 3 Instrumented. This is added to either of the above and means the use of plate and screws How much of the disc is removed ? All of it Why have a cervical fusion for a disc prolapse and not just a discectomy ? Outcomes can be similar. There is the possibility of a progressive angulation of the spine in patients who only have a discectomy. Where does the bone come from ? Bone is taken from the iliac crest (pelvis bone). Sometimes artificial or bovine (cow) bone is used. What is the risk of failure ? There are two types of failure. 1. Failure to get better. 2. Failure to fuse. You can both or either. Some patients will get a solid fusion but get no better and some will have a non solid fusion with good relief of symptoms. Most patients will fuse. Is there a chance of failure at an adjacent level ? Yes there is no doubt that the adjacent discs to fusion have a greater risk of failure Can the metal break No! This typically occurs if the boney fusion does not work Can the plate and screws work loose ? Yes ? What are the commonest complications ? Difficulty swallowing / Hoarse voice / Neck pain Will the screws need to be removed In most cases no. Some patients have the plate pushing on the gullet and need them taken out. Is there a chance the fusion will not work ? Unlikely Will the fusion remove al