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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