Spinal fusion of the cervical spine
Synonyms
Spinal stiffening, ventral spondylodesis, dorsal spondylodesis, vertebral body fusion, stiffening operation of the spine, spinal stiffening, segment stiffening, back pain, spinal column surgery, herniated disc
introduction
The standard procedure at Herniated discs of the cervical spine or Vertebral fractures of the Cervical spine is the ventral Spinal fusion (Stiffening operation). Here, the surgical access from front (ventral) elected. The vertebral body is stabilized by screws and plates. This is followed by the use of a Bone grafts from the iliac crest or the introduction of bone cement to bridge the defect. Since a spinal fusion always means a stiffening of the affected vertebral section, the indication for the operation should be made precisely.
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Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
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The spine is difficult to treat. On the one hand it is exposed to high mechanical loads, on the other hand it has great mobility.
The treatment of the spine (e.g. herniated disc, facet syndrome, foramen stenosis, etc.) therefore requires a lot of experience.
I focus on a wide variety of diseases of the spine.
The aim of any treatment is treatment without surgery.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.
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60311 Frankfurt am Main
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indication
In the case of vertebral body fractures or a herniated disc in the cervical spine area, surgical therapy as part of a ventral spinal fusion to be thought about. If there are no neurological deficits or therapy-resistant pain, a conservative therapy be sought without surgery. If there is no cure with conservative therapy, kick neurological failures on or if the pain is too severe, surgical therapy is initiated.
Surgical procedure
By default, the operation is performed via an anterior approach, i.e. the patient is in Supine position stored. First, an incision is made in the middle of the large muscle of the neck and neck area (Sternocleidomastoid muscle). The soft tissues of the neck are split open and the nerve and blood vessels are spared. The relevant Intervertebral discand bone appendages removed. If there is a fracture, it must be found and reduced. In the case of a herniated disc, the now exposed space between the two vertebral bodies is then removed by bone Iliac crest, or through Bone cement filled up. In the event of a fracture, the vertebral body is opened with the help of a H-shaped plate stabilized. After that Spinal cord and the nerve roots are exposed again, the wound can be closed. Usually a drainage inserted, which drains the wound secretion to the outside for two days. Then the surgical field is closed in layers.
Complications
Since during the surgical treatment the access leads along an important nerve and vascular compartment, large injuries can occur Vessels (Carotid artery, vertebral artery, jugular vein) and annoy come. This is especially true here Recurrent nerve as endangered. This serves to open and close the vocal folds. Also injuries from windpipe (Trachea), esophagus (Esophagus) or spinal cord can occur due to their proximity to the surgical site. Overall, however, these complications are very rare.
Aftercare
Depending on the course of the operation and the clinical condition of the patient, one physical conservation For 2 to 6 weeks recommended after surgery. Above all, extreme loads and movements in the cervical spine should be avoided. After about 8 weeks a physiotherapy therapy advised. Here, the patient should practice strengthening the neck and throat muscles under supervision. As a rule, the patient can resume normal work after 4 to 6 weeks if the neck and neck area is not stressed too much.
forecast
The prognosis of herniated discs is better, the earlier they are treated surgically if surgery is indicated. This allows a Chronification the complaints and an anatomical change in the structures Scarring be prevented. Surgery should also be performed as early as possible in the case of vertebral body fractures. In the case of nerve failure there is one absolute Operation indicationwhich should be carried out in the shortest possible time. This reduces the risk of permanent nerve damage and thereby significantly improves the prognosis.
Summary
The spinal fusion of the cervical spine is one Stiffening operation of the affected vertebral bodies, which in the context of Herniated discs or Injuries the vertebral body is carried out. The operative access is usually from front (ventral). After the affected vertebral section has been exposed intraoperatively, the fracture is reduced, or the intervertebral disc and interfering pieces of bone are removed. It is important to completely expose the previously compromised nerve root in order to permanently alleviate the symptoms and avoid nerve failure. The complications of the operation are also considered Bleeding and infection especially the injury of the cervical organs and large vessels. However, due to today's surgical technique, these complications have become very rare. Overall, the prognosis is good if the operation is carried out early if the indication is confirmed.
