Cervical fusion is a form of surgery that removes a damaged intervertebral disc in the neck, replaces it with a supportive cage or implant, and permanently fuses the adjacent vertebrae. This procedure halts some movement within a motion segment, usually with the goal of increasing stability and relieving neck pain.
The exact cause of pain in the cervical spine can be tricky to pinpoint, largely because the spine is so complex and has many components – vertebrae, facet joints, intervertebral discs, ligaments, tendons, and muscles – all of which must work properly together to ensure optimal functioning. That said, when one or more of these components is damaged, degenerates, or for some other reason begins to function improperly, pain can often result.
Common Causes of Neck Pain
Over time, the spinal components can begin to degenerate as a result of the natural aging process, and may lead to the formation of bulging discs, herniated discs, calcified ligaments, bone spurs, and other anatomical abnormalities.
Sometimes an abnormality that forms in the cervical spine can itself cause neck pain. For example, a disc that ruptures or herniates can damage the tiny nerve fibers that innervate the outer wall of the disc and cause what is known as discogenic pain. Or, the medial branch nerves in an arthritic facet joint can become inflamed and painful due to dysfunctional joint movement.
So, how exactly does cervical fusion surgery help relieve pain? Let’s go back to the example of a herniated disc causing discogenic pain. The first part of a fusion procedure involves removing a damaged disc, which would presumably eliminate pain caused by the disc itself. Once the disc is removed, a supportive cage, bone graft, and hardware are inserted to stabilize the spine.
If the vertebrae in that segment had shifted out of place due to the damaged disc, they may have been pressing upon nearby nerve roots which can result in excruciating pain. In cases like this, surgeons would do their best to realign the vertebrae and then implant a bone graft and hardware to keep the vertebrae in place, and away from sensitive nerve tissue.
Now, let’s now consider arthritic facet joints causing medial branch nerve pain. Along with disc removal, cervical fusion involves inserting plates, rods, and screws into two affected vertebrae, which permanently halts movement in painful facet joints.
Before Considering Surgery
It’s important to remember that cervical fusion, and spine surgery in general, should always be considered a last-resort treatment option for degenerative spine conditions. You’ll want to exhaust all forms of conservative, nonsurgical treatments before you even consider surgery, and your physician will likely recommend surgery only when he or she feels it’s time to explore whether surgery can relieve your neck pain.