Cervical spine fusion- Minimally invasive
Anterior cervical decompression and fusion are performed to alleviate the symptoms of cervical radiculopathy, disc herniation, myelopathy, cervical fracture, degenerative arthritis, etc. Minimally invasive cervical decompression and fusion involve performing the surgery with special instruments, implants, and techniques to minimize damage to the structures around the cervical spine.
Anterior cervical decompression and fusion surgery involves accessing the cervical spine from the front of the neck. The surgeon removes the intervertebral disc and all the structures impinging upon the neural tissue causing the symptoms. The surgeon then introduces a cage between the vertebrae that is filled with bone graft material. The two or more vertebrae are then fixed with a plate and screws.
The majority of patients experience significant relief from the procedure and return to their normal activities in 6-8 weeks. The fusion of the vertebrae stabilizes the cervical spine segment and provides relief of symptoms.
The minimally invasive cervical decompression and fusion utilize a smaller incision to perform the decompression and fusion instead of the larger traditional approach. The smaller incision limits the amount of blood loss during the surgery. The complications associated with traditional surgery such as infection, nerve damage and difficulty swallowing occur less frequently with minimally invasive technique.
The minimally invasive surgery (MIS) technique also involves less cutting of the tissues to perform the fusion. The less cutting of tissue ensures a more rapid recovery compared to the traditional approach. The smaller incision also leads to smaller scar formation and therefore is more cosmetically appealing than the traditional approach.
The pain experienced after the surgery is less intense and lasts for less time compared to the traditional approach therefore minimizing the need for NSAIDs/narcotic medications. The minimally invasive cervical fusion may also be performed on an outdoor patient basis and most patients may return home the same day of the surgery. All the above benefits dramatically cut short the recovery period of cervical fusion surgery.
During the procedure, a small incision of 1-2 inch is made on the front or side of the neck, the skin incision is usually made in the natural skin folds so the post surgery scar is minimally visible. The surgeon uses a special magnifying microscope to see through the small incision. Special instruments are used in minimally invasive techniques to gently retract the muscles and tissues to reach the cervical spine.
The surgeon then uses tiny instruments to remove the intervertebral disc and any other tissue (bone spurs, etc.) compressing the neural structures. The ends of the vertebrae are freshened to receive the bone cage (spacer) and the bone graft material. The spacer is used to maintain the space between the vertebrae and prevent compression of the neural tissue. Small plate and screws are then used to fix the vertebrae together.
Alternatively, a stand alone implant (spacer) may be used instead of the plate and screw construct. The stand alone implant spacer has screw holes that go diagonally towards the adjoining vertebrae. The stand alone implants offer the advantage of even smaller incisions in minimally invasive technique.
As with any surgery, there may be potential complications associated with minimally invasive surgery such as nonunion of fusion, broken implants, nerve damage, hoarseness of voice, etc.
Minimally invasive cervical fusion is an excellent procedure when indicated and the patients benefit from smaller incisions and less soft tissue trauma. The recovery period of patients undergoing minimally invasive cervical fusion is dramatically cut short as compared to the traditional technique.
My name is Dr. Suhirad Khokhar, and am an orthopaedic surgeon. I completed my MBBS (Bachelor of Medicine & Bachelor of Surgery) at Govt. Medical College, Patiala, India.
I specialize in musculoskeletal disorders and their management, and have personally approved of and written this content.
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