When people experience neck pain, especially when it becomes persistent, they often assume they will need surgery in order to resolve their issues. In reality, spinal surgery is reserved only for cases that meet certain criteria. One type of neck surgery, cervical fusion, may become necessary depending upon the severity of a patient’s medical condition.
Cervical Anatomy
The cervical region begins at the base of the skull and continues throughout the neck region. There are 7 vertebrae (bones) that make up the cervical area, along with 8 pairs of cervical nerves. In general, the cervical nerves innervate upper regions of the body, including the arms and hands. One pair of nerves is also responsible for innervating the diaphragm, a large muscle that assists in the breathing process. Cervical discs reside between each pair of cervical bones. These discs are made of a soft, jelly-like substance encased within a tough, fibrous exterior. The cervical discs provide cushioning between the cervical bones, thus playing a key role in the spine’s ability to absorb shock.
In some individuals, one or more cervical discs begin to flatten and bulge to the point where the disc presses upon nearby cervical nerves. In other cases, a condition known as a cervical herniated disc may occur. This is characterized by a tear in the exterior lining of the disc, allowing the inner contents of the disc to spill out and press upon adjacent cervical nerves. The disc contents may also push against the sac which houses the spinal cord. If the region where the spinal cord resides becomes impinged, this is referred to as “spinal stenosis”.
What is Cervical Fusion?
Cervical fusion surgery involves removing one or more cervical discs from the spine and fusing the two adjacent bones together. This type of surgery is generally only performed after a patient has experienced specific issues. Some of the issues include arm numbness or tingling, hand weakness, or breathing difficulties. All of these issues may indicate that one or more discs are either bulging or herniated to the point where it significantly interferes with the innervation of key areas of the body.
The purpose of cervical fusion surgery is to eliminate the pressure on either the cervical nerves or the spinal cord region to prevent further nerve or cord damage from occurring. As with any surgery, but especially with any surgery involving the spinal column, there are potentially serious risks associated with cervical fusion. This is why reputable medical professionals only recommend fusion surgery if a patient’s issues have advanced to the point where there is a significant risk to the patient’s spinal cord, arm and/or hand functioning, or their ability to breathe properly.
Even with a successful surgery, depending upon the level(s) at which the disc was removed, patients may experience some loss of range of motion when moving their heads. Some patients have complete pain relief after recovering from fusion surgery, but others continue to experience pain and other uncomfortable symptoms such as headaches. Over time, the two cervical discs nearest to the (removed) disc may begin to deteriorate at a faster rate since they now have to provide extra shock absorption previously managed by the missing disc(s).
How Does Physical Therapy Help?
Some patients exhibit the initial signs of a bulging or herniated disc but are not yet candidates for cervical fusion. This is actually great news. In many of these cases, physical therapy can help patients avoid surgery altogether by incorporating therapies designed to decrease pain to manageable levels and increase strength in key muscles that provide essential support for the cervical area.
In patients that did undergo cervical fusion surgery, post-operative recovery typically includes a series of physical therapy treatments as well. Post-op physical therapy treatment can help decrease any lingering pain after surgery, help ensure that patients retain as much range of motion as possible, and introduce exercises that strengthen the muscles associated with the remaining adjacent discs.
If you are suffering from persistent neck pain or need post-op PT, we can help. Please contact Cawley Rehab at 570-208-2787 or email us at: cawleyptfrank@gmail.com.
