What is it?

Anterior cervical fusion is an operation performed on the upper spine to relieve pressure on one or more nerve roots, or on the spinal cord. The term is derived from the words anterior (front), cervical (neck), and fusion (joining the vertebrae with a bone graft).

Why is it done?

When an intervertebral disc ruptures in the cervical spine, it puts pressure on one or more nerve roots (often called nerve root compression) or on the spinal cord, causing pain and other symptoms in the neck, arms, and even legs. In this operation, the surgeon reaches the cervical spine through a small incision in the front of the neck. After the muscles of the spine are spread, the intervertebral disc is removed and is replaced with a small plug of bone, which in time will fuse (join) the vertebrae it lies between.

Obtained from a bone bank, the preformed bone plug will not be rejected by your body because it is vascular (contains no blood cells). In some circumstances, or at the preference of your surgeon, the bone plug might instead be removed from your own hip through a second incision.

Removing the Cervical Disc

After a retractor is used to pull aside fat and muscle, the disc is exposed between the vertebrae. Part of it is removed with a forceps. Then a surgical drill is used to enlarge the disc space (top illustration), making it easier for the surgeon to empty the intervertebral space fully and remove any bone spurs. Afterwards, only a single ligament separates the surgical instruments from the spinal cord and nerve roots.

Placing the Bone Plug

The bone plug is placed in the disc space, where it will begin to fuse the vertebrae it lies between (bottom illustration).