Neck fusion can be the operative choice for some disorders of the neck.  Some of the reasons to fuse the neck from the back (posterior cervical fusion) include avoidance of late deformity, failed attempted fusion from the front, fusion for neck pain, fusion for fractures, and halting the progression of deformity.   The ultimate goal of the operation is to fuse two or more bony segments in the neck into one single solid bone.  This will limit motion in that segment only which may avoid pain, prevent deformity, and can stop dynamic compression over neural structures.

In cases of fractures or dislocations of the spine, a fusion procedure can stabilize the neck and prevent further neural compression, further injury, late deformity, while providing greater chance for recovery.   

In cases which the bony elements press on the spinal cord (spinal stenosis) a laminectomy and decompression can be performed to create more space for the spinal cord.  Bone is removed from the back of the spine in the neck area to create more space.  By doing so, the patient is placed at risk for future deformity.  The surgeon must find a balance to remove enough bone to create enough room, but avoid removing too much bone that may create late deformity of the bony elements in the neck.  One way to prevent late deformity after a decompression procedure is a fusion of the bony elements which is again referred to posterior cervical fusion. 

Surgeons usually use bone grafting to enhance chances for bony fusions.  Bone grafting means placement of extra bone in the area to be fused.  Donor bone can be obtained from the pelvis of the patient or can be obtained from a bone bank which is similar to blood banks.  Bone banks provide bone harvested from cadaveric specimens and undergo rigorous testing before usage.  These tests are performed to minimize the risk of disease transmission.  The use of bone from a bone bank avoids a second incision and the operative risk in the area of bone harvesting from the patient.  However, better fusions rates have been obtained from bone harvested from the patient (Autologus bone grafting). 

Eliminating motion from an area to be fused increases the chance for fusion.  Spine surgeons can utilize metallic implants to stop motion in specific areas until solid bony fusion takes place.  Placement of metallic implants are referred to as Instrumentation.  The addition of instrumentation to a fusion procedure adds certain risks and benefits to the proposed operation.  These implants add rigidity to the fusion area and certainly enhance fusion rates.  However, they increase operative risk by increasing operative time, increasing risk for infection, and increasing risk for neural injury during the operation.  Most surgeons however, agree and do utilize instrumentation for fusion procedures to the back of the neck.  The reason for such approach is that stabilization of the neck is very difficult with braces or external stabilizers.  Even if stability is achieved by bracing or casting, they are poorly tolerated by patients to wear for 3 or more months.   Two forms of instrumentations are available to stabilize the spine and optimize fusion.  One type is the use of titanium plates and screws and the other is the use of stainless steel wires.  Both of these techniques have been used successfully and are surgeon dependent. 

As with any surgical procedure, risks, benefits, and alternatives should be discussed with your surgeon.  Operative risks are unique to the condition treated and may include bleeding, infection, neural injury, hardware failure, etc.  The discussion of all possible complications is beyond the scope of this web page and is best described by your own physician.