What is Posterior Cervical Fusion (PCF)?

Posterior cervical fusion surgery 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, cervical fusion surgery 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, cervical fusion surgery is performed less frequently than anterior cervical fusion (ACF).


What Conditions are Treated with Posterior Cervical Fusion?

  • Cervical myelopathy
  • Cervical kyphosis
  • Cervical spondylolisthesis
  • Cervical stenosis
  • Failed anterior surgery
  • Pseudoarthrosis of anterior fusion attempt
  • Ankylosing Spondylitis deformity
  • Cervical deformity
neck pain surgery
Posterior Cervical Fusion


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 the cervical fusion surgery.
  • If you take prescription medications or other drugs, including herbals, ask your doctor how soon you should stop taking these before the cervical fusion surgery.
  • 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 cervical fusion surgery, you will be asked to sign permits for surgery, anesthesia, blood and blood products.
  • 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.
  • A bone graft is placed in the area to be fused.
  • Often, screws or wire will be used to help provide stability.
  • Cervical fusion surgery takes approximately 2-4 hours.
  • 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 cervical fusion surgery 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.