Posterior Cervical Decompression and Fusion
What is Posterior Cervical Decompression and Fusion?
Posterior cervical decompression and fusion (PCDF) is a surgical procedure designed to relieve pressure on the spinal cord and nerve roots in the cervical spine while stabilizing the affected vertebrae. This procedure is typically performed through an incision in the back of the neck (posterior approach) and is used to treat various degenerative and traumatic conditions that cause spinal instability or nerve compression. The surgery involves removing portions of the bone and soft tissues compressing the nerves (decompression) and then stabilizing the spine using a bone graft and instrumentation (fusion).
This procedure is recommended for patients experiencing significant neck pain, radiating pain and numbness into the arms, and other nerve-related symptoms or spinal instability. It is offered when a patient has not responded to conservative treatments, such as physical therapy, medications, or injections, and when these conditions exist:
- Cervical Spinal Stenosis – Narrowing of the spinal canal that compresses the spinal cord or nerve roots.
- Herniated Discs – Displaced intervertebral discs that press on nerve structures.
- Degenerative Disc Disease – Wear and tear on the cervical discs leading to instability and pain.
- Cervical Myelopathy – Spinal cord dysfunction caused by compression, leading to weakness, numbness, or coordination and balance difficulties.
- Cervical Radiculopathy – Pinched nerve roots causing radiating pain, weakness, or numbness in the arms.
- Spinal Trauma or Fractures – Injury-related conditions that compromise spinal stability.
- Cervical Deformities – Conditions such as kyphosis that require surgical correction.
Before considering surgery, Dr. Boden typically recommends a course of conservative treatments, such as physical therapy, anti-inflammatory medications, activity modification, and epidural steroid injections. However, if symptoms persist for several months, worsen, or significantly impact daily activities, a posterior cervical decompression and fusion may be the best option for relief.
Dr. Boden will access the cervical spine from the back of the neck and remove bone and tissue, such as bone spurs, herniated disc material or thickened ligaments that are compressing the spinal cord or nerve roots. This is decompression surgery to relieve symptoms that developed from the above listed conditions. Once the compression is relieved, she will insert screws and rods to fuse the cervical vertebrae to stabilize the spine.
Recovery from PCDF varies depending on the patient’s overall health, the number of treated vertebrae, and adherence to post-surgical guidelines. Dr. Boden will provide postop instructions to follow after surgery. They may include:
- Taking pain medications.
- A soft cervical collar may be recommended for additional support and comfort.
- Avoiding heavy lifting, twisting, or excessive bending of the neck for six weeks.
Bone fusion typically takes several months to complete. Follow-up X-rays or imaging scans may be performed to assess fusion progress.
- Symptom relief – relieving radicular arm pain, numbness, tingling and weakness due to compression of a nerve root.
- Improved function
- Relieve compression to restore function and sensation and improve quality of life.
- Potential new or persistent pain which may be managed with pain medications
- Fusion failure (pseudoarthrosis)
- Infection
Most patients experience significant pain relief and improved function following posterior cervical decompression and fusion. A soft cervical collar may be provided for additional support and comfort. Patients are instructed to avoid heavy lifting, bending, and twisting for the first six weeks. Walking is highly encouraged. Once the soft tissues heal and bony fusion has begun to solidify around six weeks, the activity restrictions are lifted and formal physical therapy may be initiated as needed to assist with neck mobility and strengthening. Significant recovery is typically seen in 3 months, though patients may see improvement in symptoms up to a year after surgery. Long-term success depends on factors such as overall health, adherence to post-surgical care, and lifestyle modifications to protect spinal health. Regular follow-up appointments with Dr. Lauren Boden, M.D., are essential to monitor healing and ensure optimal recovery.
Dr. Lauren Boden, M.D., evaluates each patient’s condition to determine if Posterior Cervical Decompression and Fusion is the best treatment option. Non-surgical approaches, such as physical therapy, medications, and injections, are often explored before considering surgery. However, for patients with severe nerve compression, persistent pain, or spinal instability, PCDF offers a proven, effective solution.
For individuals suffering from cervical spine disorders, this procedure can provide long-lasting relief and restore function. If you are experiencing chronic neck pain, radiating arm symptoms, or difficulty with daily activities, schedule a consultation with Dr. Boden to explore your treatment options.
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About Our Team
- Fellowship-Trained Orthopedic Surgeons
- Assistant Professors of Orthopedic Surgery, University of Louisville
- Authors of orthopedic research and publications
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