Posterior Cervical Decompression and Fusion

What is Posterior cervical decompression and fusion (PCDF)?

Cervical posterior decompression and fusion is a surgical procedure used to treat the narrowing of the cervical canal which puts pressure on the spinal cord.

Broken down:

• Cervical = Neck (vertebrae)
• Posterior = Rear or to the back
• Decompression = To remove pressure (in this case, from the spinal cord)
• Fusion = To join two or more things together to create one (vertebrae are fused together).

Cervical posterior decompression and fusion is used to decrease neck and arm pain and stop the symptoms of nerve compression. It can also be used to help an unstable spine from getting worse. Doctor Brenton Pennicooke, a spinal neurosurgeon, treats patients Saint Louis, Creve Coeur, and surrounding cities in St. Louis County, Missouri who are experiencing the symptoms of spinal compression and who could benefit from a cervical posterior decompression and fusion.

What does cervical posterior decompression and fusion treat?

Posterior cervical decompression and fusion is typically used to treat patients with the following:

• Cervical disc herniation
• Cervical stenosis
• Cervical arthritis
• Cervical myelopathy
• Bone spurs in the cervical spine
• Spinal cord compression
• Spinal instability
• Radiculopathy
• Tumors in the spine
• Spinal infections
• Spinal cancer

Why would I need cervical posterior decompression and fusion?

Patients who are experiencing neck and arm pain or numb and weak hands may benefit from PCDF. If cord compression has progressed to causing mobility issues or neurological function, surgery is often recommended. Fusion is often recommended to stabilize the cervical vertebrae to protect the spinal cord from further injury, which can include paralysis.

What is done during cervical posterior decompression and fusion?

Dr. Pennicooke will individualize this procedure based on the needs of the patient. In general, patients can expect the following:

• General anesthesia is administered and the patient is positioned on a special surgical table, face down.
• An incision is made in the back of the neck, along the affected area of the spine.
• Muscles are retracted and held aside in order to see the spine.
• If necessary, surgical screws are placed at the necessary levels of the spine.
• The central lamina and spinous process is carefully removed, allowing the spinal cord and affected nerves to decompress.
• A bone graft either from the patient (autograft) or from a bone bank (allograft) is used along with a specialized rod are all placed and secured in place along the previously positioned screws, to promote fusion.
• The surgery is completed steps, to secure the area, replace the moved muscles and ligaments, and to close the small incision.

How long is the recovery after cervical posterior decompression and fusion (PCDF)?

Patients are usually placed in a post-surgical collar, or c-collar to aid in immobilization. The collar should be worn 24 hours a day, with a special collar for showering, for approximately 3 months. At times, Dr. Pennicooke can liberalize the use of the collar depending on the patient’s bone quality.

Pain medication will be prescribed and should be used only as directed by Dr. Pennicooke. Patients should not lift anything over 5 pounds until cleared to do more. Steps should be taken to avoid bending, twisting or turning the neck as much as possible for the initial 3 months. Based on each individual patient’s healing ability, driving and light daily activities usually are allowed after the first follow-up appointment.

Complete fusion can take 6-12 months and neck pain will resolve with time and further healing.