Name of the Procedure:

Arthrodesis, anterior interbody; cervical below C2, including disc space preparation, discectomy, osteophytectomy, and decompression of spinal cord and/or nerve roots (each additional interspace)

Summary

Arthrodesis anterior interbody is a surgical procedure by which the bones in the spine are fused together using bone grafts. This fusion is performed on the cervical spine below the second cervical vertebra (C2), and it involves the removal of intervertebral discs, bone spurs, and decompression of the spinal cord and/or nerve roots.

Purpose

The main goal of this procedure is to alleviate pain, restore stability, and improve the function of the cervical spine. It treats various spinal conditions, such as degenerative disc disease and cervical spondylosis, by providing long-term stability through bone fusion.

Indications

• Chronic neck pain unresponsive to conservative treatments
• Cervical disc herniation
• Cervical spondylotic myelopathy
• Spinal stenosis
• Instability of the cervical spine
• Severe osteoarthritis with bone spurs compressing the spinal cord or nerves

Preparation

• Patients may be required to fast for 8 hours before the procedure.
• Medication adjustments may be necessary, especially for blood thinners and diabetes medications.
• Pre-operative imaging studies like MRI or CT scans to assess the spine.
• Blood and urine tests to ensure the patient is fit for surgery.

Procedure Description

1. Anesthesia: The patient is given general anesthesia.
2. Incision: A small incision is made in the front of the neck to access the cervical spine.
3. Disc Space Preparation: The surgeon removes the problematic intervertebral disc (discectomy) and cleans the area.
4. Osteophytectomy: Any bone spurs are removed to relieve pressure on the spinal cord and nerve roots.
5. Decompression: The spinal cord and nerve roots are decompressed to provide relief from symptoms.
6. Fusion: Bone graft or a synthetic substitute is placed into the cleaned disc space, and sometimes metal plates or screws are used to ensure stability during the fusion process.
7. Closure: The incision is closed with stitches or surgical glue.

Duration

The procedure typically takes between 2 to 4 hours, depending on the number of interspaces being fused.

Setting

This surgery is performed in a hospital or a specialized surgical center.

Personnel

• Orthopedic surgeon or neurosurgeon
• Anesthesiologist
• Surgical nurses
• Operating room technicians

Risks and Complications

• Infection
• Blood loss
• Nerve damage
• Difficulty swallowing or speaking
• Failure of the bone graft to fuse (nonunion)
• Persistent pain or discomfort

Benefits

• Relief from chronic neck pain
• Increased stability and function of the cervical spine
• Improved quality of life
• Reduced risk of further spinal degeneration

Recovery

• Hospital stay: Typically, 1-3 days post-surgery.
• Pain management: Prescription pain medications.
• Physical therapy: May be required to regain strength and mobility.
• Restrictions: Avoid heavy lifting and strenuous activities for several weeks.
• Follow-up: Regular appointments to monitor the fusion process.

Alternatives

• Conservative treatments (physical therapy, medications)
• Cervical disc replacement
• Posterior cervical fusion
• Epidural steroid injections

Patient Experience

• During surgery: The patient will be under general anesthesia and won't feel pain.
• Post-surgery: Mild to moderate discomfort, swelling in the surgical area, managed with pain relief.
• Long-term: Gradual improvement in symptoms, depending on recovery and adherence to post-operative guidelines.
• Ongoing: Periodic monitoring and imaging to ensure successful fusion and spinal health.

This comprehensive guide aims to inform the patient about the Arthrodesis anterior interbody procedure, ensure understanding of the care journey, and promote well-informed decision-making regarding cervical spine health.