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Reasons for a Cervical Spinal Fusion

by Dr. Sam Vaid, PT, DPT

If neck pain is keeping you from performing daily tasks or doing the things you enjoy, cervical spinal fusion may be a treatment option. This procedure involves joining the spine bones of neck region to improve stability and potentially alleviate symptoms caused by nerve or spinal cord compression. Depending on the underlying problem, cervical fusion may be beneficial for certain types of acute and chronic cervical spine disorders.

Disc Herniation

Your backbones are separated by cushions called intervertebral discs, which act as shock absorbers. A cervical disc herniation occurs when an intervertebral disc in your neck is pushed out of place. The displaced disc may press against nearby nerves and cause neck pain. Other possible symptoms include radiating pain, tingling and numbness down your shoulder and arm. Cervical disc herniation may keep your from performing activities such as typing, writing and lifting due to pain and weakness in your arm and hands. According to a 2011 review published in the "Musculoskeletal Journal of Hospital for Special Surgery," 75 to 90 percent of people with symptoms due to cervical nerve compression improve without surgery. For those people whose symptoms are not alleviated by nonsurgical treatment, cervical spinal fusion may be an option. Approximately 90 percent of people who undergo cervical spinal fusion with disc removal experience symptom relief from the procedure.

Cervical Spondylotic Myelopathy

Cervical spondylotic myelopathy is a slowly progressive disorder caused by degeneration of the neck vertebrae and discs that leads to spinal cord compression. This condition is the most common spinal disorder among Americans age 55 and older. In most cases, the degenerative changes of the cervical spine are age-related. Spinal cord is compression associated with cervical spondylotic myelopathy typically causes neck stiffness and neck, shoulder and arm pain. Other signs and symptoms may include weakness of the arms and hands; clumsiness and dropping items; leg weakness; and unsteadiness when walking. Surgery may be a consideration for some people with cervical spondylotic myelopathy. The goal of surgery is to relieve pressure on the spinal cord by removing discs, pieces of bone or both that are causing compression. In many cases, cervical fusion is performed at the same time to stabilize the spine in the affected region. The decision whether to have surgery and, if so, what type should be discussed with your doctor. She will explain the potential risks and benefits, and help you make an informed decision.

Unstable Fracture

A surgical fusion is commonly recommended if you experience a neck fracture that compresses a nerve or causes instability of your cervical spine. This type of injury typically causes sudden neck pain, stiffness and may be associated with profound numbness and weakness of your arms and legs. Immobilizing the neck with traction or a brace may be a treatment option in some cases. However, cervical fusion is often necessary for severe fractures, especially if the vertebrae are dislocated and pressing on nearby nerves or the spinal cord. Cervical fusion can relieve pressure on the affected nerves and protect the spinal cord by stabilizing the spine.

Spinal Tumors

A spinal tumor that causes fractures, spinal cord compression or instability is another possible indication for cervical spinal fusion. Symptoms of cervical spinal tumors vary but may include clumsiness of the hands, trouble walking, neck and arm pain, weakness and numbness. You also may fall frequently due to balance problems. The fusion itself will not remove the tumor, but is performed to help stabilize the spine and relieve pain and other symptoms.

About the Author

Dr. Sam Vaid is a human performance expert with advanced training in the areas of orthopedics, sports medicine, nutrition, wellness and sports performance. He is an educator, writer and clinical researcher for organizations including the American College of Sports Medicine, Lance Armstrong Foundation, "Journal of the American Physical Therapy Association" and Time Inc.

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