Posterior Cervical Fusion with Instrumentation
Robert Louis, MD specializes in Posterior Cervical Fusion with Instrumentation in Orange County
Robert Louis, MD, your Orange County Neurosurgeon, performs Posterior Cervical Fusion (PCF) to treat patients suffering from cervical fractures or instability and other spinal conditions, such as tumors, infections, and deformity. It may also be performed together with multi-level anterior cervical surgery.
Benefit of Posterior Cervical Fusion
Reduction in pain
Reduction in continuing spine degeneration
Improves quality of life
Posterior Cervical Fusion Procedure
Your physician will review your condition and explain all of your treatment options, including medications, physical therapy, and other surgeries such as removal of the diseased disc, fusion, etc. You will be required to fast the evening before surgery and you may need to stop taking some medications in advance of the procedure. These medications may include aspirin and nonsteroidal anti-inflammatory drugs, as well as blood thinners. Additionally, all nutritional supplements need to be stopped at least one month prior to surgery. Before your surgery you will meet with a spine surgeon to review the surgery, the area of the cervical spine being operated on, and sign consent forms. He or she will discuss potential risks and benefits of the procedure and this is a good time to ask questions. You may be measured for a cervical collar or brace prior to surgery. Your surgeon may also schedule you for a pre-surgical medical evaluation.
PCF is a surgical procedure that fuses two or more cervical spine bones together along the sides of the bone using a posterior incision. Bone graft or bone graft substitute is placed along the sides the spine bones, which over time, fuses together. PCF may be performed with or without a posterior decompression (laminectomy) and/or instrumentation (use of metal screws or rods), which contributes to stability especially with multi-level fusions and increases success rate of fusion.
Most patients are able to go home 3-5 days after surgery. Before patients go home, physical therapists and occupational therapists work with patients and instruct them on proper techniques of getting in and out of bed and walking independently. Patients are instructed to avoid excessive bending and twisting of the neck in the acute postoperative period (first 1-2 months). Patients can gradually begin to bend and twist their neck after 2-3 months after the fusion solidifies and the pain subsides. Patients are also instructed to avoid heavy lifting in the postoperative period (first 2-4 months).
Brace– Most patients are required to wear a neck brace post-surgery to reduce the pain and stress on the neck area and help improve bone healing.
Wound Care– The wound area should remain covered with a gauze bandage secured in place with tape. The area should be kept clean and dry. The bandage should generally be changed every 1-2 days, especially after showering.
Showering/Bathing– Patients can shower immediately after surgery, but should keep the incision area covered and dry, avoiding the water from hitting the wound. Bandage should be changed every 2-3 days. Patients should wait about 2 weeks when the wound has healed before soaking in a tub.
Driving– Patients may resume driving about 2-3 weeks after the surgery when the pain has decreased and when the neck range-of-motion has improved. Patients should not drive while still taking pain medications. Patient must be accompanied when driving in case the pain is felt and they need help driving back home.
Return to Work and Sports– Patients may return to light work duties around 2-4 weeks after PCF procedure. Patients may return to moderate level of work and light sports activities about 3 months after the surgery, when the pain has subsided and the neck strength and mobility has stabilized with physical therapy. Patients who have undergone single-level cervical fusion may return to heavy work and sports activities once the surgical pain has subsided and the neck strength and mobility has stabilized after physical therapy. Patients who have undergone multi-level cervical fusion are recommended longer rest and advised to avoid high-impact sports and heavy work.
Doctor’s Visits and Follow-Up
Patients will return for a follow-up visit to see Dr. Louis about 12-14 days after PCF procedure. Medications will be refilled if necessary. During the follow up visit, Dr. Louis will check the incision and the stitches or staples will be removed and X-ray will be taken to check if the fusion area is stable and if it’s healing properly. Patients will be asked to return for more follow up visits about 4-6 weeks after initial follow up visit. Around 8-12 weeks after surgery, patient will be given a prescription to begin physical therapy to help improve range of motion.
For more information on Posterior Cervical Fusion with Instrumentation or to request an appointment with Dr. Louis, please call (949) 383-4185 or Contact Us.