Posterior Cervical Fusion (PCF)

Description

Posterior cervical fusion (PCF) is a spinal fusion surgery in the neck, or cervical, spine. The surgeon makes an incision in the back of the neck. The neck muscles are retracted, providing access to the spine. Often, PCF is performed combined with a decompression surgery. Bone graft is placed, and often screws or surgical wire is used at the fusion level to provide stability. In general, PCF is performed less frequently than anterior cervical fusion (ACF).

Conditions Treated

PCF may be performed for the treatment of spondylosis, stenosis, nerve compression, fracture and in patients with previous cervical spine surgery.

Before the Procedure

Once you have decided to have surgery, the following events take place:

  • A medical examination.
  • Chest x-ray, EKG and blood work.
  • You may be asked to have a neurological or psychological examination.
  • If taking aspirin or anti-inflammatory medications daily, stop these medications at least one week before surgery.
  • If you take prescription medications or other drugs, including herbals, ask your doctor how soon before surgery you should stop taking these.
  • Do not have anything to eat or drink for 6 to 8 hours before surgery.
  • You will check into the hospital the morning of surgery.
  • Prior to surgery, you will be asked to sign permits for surgery, anesthesia, blood and blood products.

During the Procedure

  • The surgeon makes an incision in the back part of the neck.
  • Fluoroscopy (live x-ray) is used to determine the correct level(s) to be operated.
  • Muscles in the neck are gently retracted to the side so that the spine can be seen.
  • Bone graft is placed in the area to be fused.
  • Often, screws or wire is used to help provide stability.
  • Surgery takes approximately 2-4 hours.

After the Procedure

  • You will be in the recovery room from 1 to 1½ hours.
  • The surgeon will contact your family while you are in recovery.
  • After going to a hospital room, you will be able to use a PCA pump to get medication for pain control. This machine controls the amount of medication that can be received.
  • Staff will usually get you out of bed shortly after surgery.
  • The hospital stay is usually 1-2 days.
  • A brace or collar is prescribed to restrict bending and promote healing of the fused area.
  • You will be given any needed prescriptions and discharge instructions.
  • A set of exercises that you can do at home will be provided.
  • You will be able to ride in a car or plane upon leaving the hospital.
  • It is important to avoid turning your head and bending your neck excessively.
  • Physical therapy is usually initiated after the first office visit with your doctor following surgery.

Recovery from PCF varies greatly among patients and is dependent on the extent of the surgery as well as the age and health of the individual. Return to work also varies greatly among patients and is related to overall health and the type of work you do. The type of collar used may limit your ability to drive safely for a period of time.