Cost of cervical spinal fusion by state

What is cervical spinal fusion?

Cervical spinal fusion is also known as anterior cervical decompression and fusion. This is a surgical procedure that helps decrease pain from a herniated disc in the neck. This procedure can also be performed for spinal stenosis.

The cervical spine refers to seven vertebrae in the neck area that support the skull and move the spine.  These are labelled as C1 through C7, depending on the anatomic location. The vertebrae are separated by an intervertebral disc that helps cushion the vertebrae and prevent collapse. 

Over time and with aging, the disc can herniate, or break, resulting in the inside material of the disc, called the nucleus pulposus, to push outward toward the foramina of the vertebrae, where the nerve root is located. This process can cause pain, tingling in the arm, and decreased arm strength. These symptoms can worsen over time.

Is cervical fusion major surgery?

Cervical fusion is considered a major surgery. This procedure is performed under general anesthesia. It involves removal of the intervertebral disc and manipulation of parts of the spinal cord. The procedure can take between one and three hours, depending on the severity of the disc disease.

How painful is neck fusion?

During the neck fusion surgery itself, you are under general anesthesia so you will not feel any discomfort.

After the surgery is completed, you will likely feel pain and soreness in the neck.  You will be given oral pain medication and possibly intravenous pain medicines to help relieve your discomfort.  You may also be given a pain pump, which releases pain medication into your veins when you push a button.  This helps give you pain relief more quickly and keep your pain medication dosing schedule up to date.

What happens when your neck is fused?

The neck fusion involves removal of the damaged intervertebral disc, followed by insertion of a piece of bone graft, which helps prevent collapse of the vertebrae. The bone graft material is sometimes taken from the patient’s pelvic area through a small incision. Additionally, metal, screws, and pins may be used to help stabilize the cervical region. This enables two adjacent vertebrae to fuse together and become more stabilized and prevents motion, which can cause pain.

How long does it take to recover from cervical fusion?

Recovery time from cervical fusion varies based on many factors, including the extent of the surgery, extent of your symptoms, as well as your age and other medical conditions. 

In general, the procedure takes at least 4-6 weeks to recover from cervical fusion, and up to six months to recover from the surgery if you have underlying conditions, such as diabetes.

The time frame for bone fusion, when the bones of the vertebrate join together and provide a fully stabilized area, can take about 1 year.

Can you move your neck after cervical fusion?

One your cervical spine is fused, you will have decreased neck motion in that area. However, you should not notice major disruption in your range of motion, since the neck areas above and below the surgery area help you compensate for this.

What is the success rate of cervical fusion?

The success rate of cervical fusion surgery depends on many factors, including the expertise of the surgeon, the severity and length of time of your symptoms, your age, and underlying medical conditions.

In one study, there was 85-95% improvement or resolutions of the neurologic symptoms for which the cervical fusion was performed. In 5-15% of spinal fusion surgeries, a condition called pseudoarthrosis can occur. In these cases, bone formation does not occur and the cervical vertebrae do not fuse together as intended, which can cause bone instability and pain with movement.

Another potential complication of cervical fusion surgery is called adjacent segment disease, in which the vertebrae above or below the area of the spinal fusion become stressed due to the change in anatomy and the attempts at compensation for the fused vertebrae. This can cause neck pain as well as arm tingling or weakness.  Smoking is a major risk factor for this condition. The risk of this condition developing is about 3% per year.

Pseudoarthrosis and adjacent segment disease are initially treated conservatively, without surgery.  Surgical intervention for these conditions is usually reserved for patients with severe and ongoing symptoms that are refractory to other treatments.