With any surgery, there is a risk
of complications. When surgery is
done near the spine and spinal cord
these complications (if they occur)
can be very serious. Complications
could involve subsequent pain and
impairment and the need for additional
surgery. You should discuss the complications
associated with surgery with your
doctor before surgery. The list of
complications provided here is not
intended to be a complete list of
complications and is not a substitute
for discussing the risks of surgery
with your doctor. Only your doctor
can evaluate your condition and inform
you of the risks of any medical treatment
he or she may recommend.
Anesthesia - Any operation
that requires some type of anesthesia
can be potentially harmful. Surgery
on the cervical spine usually requires
that you be put under general anesthesia.
General anesthesia means that you
are put to sleep. Anesthesia carries
a risk of allergies to the medications.
There are also different life-threatening
situations that can occur during anesthesia.
It is extremely unlikely that these
complications will occur, but you
should be aware that they are possible.
Infection - Any surgery
involving an incision in the skin
can become infected. In addition,
the bone graft and area around
the spine may become infected.
An infection will usually require
some type of antibiotic medication
to treat the infection. If the
infection involves the bone, it
may require one or more additional
operations to drain the infection.
The risk of infection is probably
less than one percent.
Blood
Vessel Damage - There are
large arteries and veins that
travel through the neck into the
brain. The carotid artery and
the jugular vein are nearby. It
is possible to damage these blood
vessels during the surgery. Again,
it is extremely unlikely that
this will occur, probably less
than one in a thousand.
Nerve
Damage - There are nerves
in the neck that travel along
the area where the incision is
made to perform an anterior cervical
discectomy and fusion. These nerves
go to the vocal chords. There
is the possibility that these
nerves can be damaged during surgery.
This can lead to hoarseness. If
this occurs, it will usually recover
unless the nerve is permanently
damaged or cut. Again, this is
unlikely.
Spinal
Cord Damage - Operations that
are performed on the cervical
spine out of necessity place the
spinal cord at risk for injury.
Spinal cord damage is probably
much more likely in the larger,
more serious operations such as
the corpectomy and strut grafting
procedures. These are complex,
difficult operations and are done
for extremely serious problems
that are unlikely to respond to
any other type of treatment.
The
routine anterior discectomy and
fusion is a common operation that
is extremely safe. While damage
to the spinal cord is possible,
it is highly unlikely.
Graft
Displacement - One of the
more common problems that can
occur after an anterior cervical
discectomy and fusion is that
the bone graft may move out of
position. If it moves too much,
it may require a second operation
to place a new bone graft in its
place.
Non-Union
- In spite of a successful operation
and good bone graft, a fusion
may not occur between the vertebrae.
This is termed a non-union. Usually
your surgeon will be able to tell
if a fusion has occurred by looking
at X-rays taken over a three to
six month period following the
surgery. If a fusion does not
occur and you have no pain, a
second operation will not be necessary.
If you continue to have pain,
and a non-union is diagnosed after
surgery, your surgeon may suggest
a second attempt at fusion. When
trying for the second time after
a failed fusion, most surgeons
will usually include some type
of internal fixation, such as
a plate and screws.
Rehabilitation
Your
doctor may have you see a physical
therapist who will design a neck-care
program just for you. Your physical
therapist will evaluate your condition
and design a program to ease your
pain and help your neck move better.
You will also be given ways to
take care of your neck so you
can avoid pain and prevent further
injury to your neck.
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