Dr. (Prof.) Shankar Acharya

M.B.B.S., M.S. (Ortho), DNB (Ortho), FRCS (Edinburgh), FRCS (Glasg.), M.Ch(Ortho) Liverpool. , FRCS (Ortho) U.K,
Senior Consultant : Endoscopic, Microscopic
and Minimal Invasive Ortho & Spine Surgeon
Scoliosis and Severe Deformity Correction Surgery Specialist

 

cervical-plating

Introduction

Cervical body fixation is a technique where we fix up two or more vertebrae together through plates and screws so as to give stability to the spine. It is an open surgery mainly indicated in patients with degenerative cervical spine or pathologies like Malignancy or myelopathy or cervical spine fractures.

Normal cervical spine anatomy

Cervical column is made up of 7 cervical vertebrae. It makes our neck and is responsible for all the neck movements. As in normal day to day activities most of neck movements are used, it is more common to undergo degeneration i.e. age related wear and tear.

How will I be benefited out of the surgery?

• It will help relieve the neck pain and arm pain and hence set you pain free.
• It will make the spine rigid and fixed and hence functionally stable.
• Maintains the proper curvature of the spine.
• Quicker return to daily activities and work. Patient can get up and walk next day itself.

How is the surgery performed?

It is an open surgery usually done through an anterior approach. Usually it is done with fusion for better spinal stability. Fusion can be done either through a bone graft or BMP or fusion implants in between the two vertebral bodies so as early fusion can be initiated and hence, a successful operation. The incision size depends upon the number of bones to be stabilized or fixed up. Usually a two inch incision is made over the anterior neck; on the right or left of the neck a horizontal
incision is made. The muscles are cut and retracted so as to reach to the bony spine. Minimal musculature has to be dissected through an anterior approach and thus quicker healing is there. The motion segments that are to be stabilized, is fixed through the plate and screws are inserted in each vertebrae. This way the spine is made to be stable and rigid.

FAQ’s

Am I a candidate for surgery?

If you are having any of the following mentioned symptoms, then you are an active candidate for surgery:

• Severe pain in neck with weakness of the hands- disturbing your quality of life,
• Imbalance in walking
• Recent changes in writing
• Difficulty in buttoning and unbuttoning of shirt.

Is it necessary to undergo the surgery immediately?

Immediate spine surgery is only necessary in cases acute radiating pain or progressive weakness of your upper limbs and numbness. If you are having balance and joint problems.
Is there any contra-indication of surgery?

• Severe osteoporosis
• Many co-morbid conditions.
• Any blood clotting disorder.

What are the Risks and Complications of the procedure?

Generally it is a safe procedure but some complications may occur due to anesthesia and the surgery which are :-

• Pain, chest complication, nausea and vomiting due to the side effects of anesthesia.
• Infection may occur as a complication.
• Bleeding may occur from the incision site.
• Wound dehiscence.
• Recurrent laryngeal Nerve root damage.
• Voice hoarseness.
• Screw misplacement or breakage may occur while the procedure.
• Difficulty swallowing due to esophagus retraction post-operatively.
• Weakness numbness paralysis are rare.
However, the above complications for fixation spine surgery are quite rarely seen in only 1-2% cases.

Is there any alternative to the surgery?

Yes, if pain is mild then patient can keep taking the medicines and physiotherapy and live with the pain.
If the patient has developed weakness and numbness and severe pain then surgery is the only treatment left.

How much will be the cost of the surgery?

Usually the surgery will cost from 2 lakhs to 3 lakhs depending upon the level(s) of fixation and implants used. And also on the room you are planning to take in the hospital.

Does this procedure come under Insurance policy?

Yes, for undergoing cervical fixation, you can have your insurance cover. You can confirm the same once with our Admission desk/ TPA desk. You can take along your insurance card and policy.

What is the success rate of this surgery?

The success rate for cervical spinal fixation ranges from 80 percent to over 90 percent, depending upon the procedure, level(s) fixation and patients’ general health condition.

How much time is required for surgery?

It takes around 1-3 hours or more to perform the surgery.

Do I need to perform any test prior to surgery?

Yes, there are a set of test known as PAC (Pre Anesthetic check up) that you are required to undergo before surgery so as to be declared FIT for surgery by the anesthesia team.

Will the surgery be performed under local or general anesthesia?

This procedure is generally done under general anesthesia.

How much time do I need to stay in hospital?

One day before surgery you need to be admitted in the hospital so as our team can perform the essential tests required before surgery. And you will be discharged on the 2nd or 3rd day depending upon your general health condition.

Will it relief my pain immediately?

Yes, the radicular pain that was coming to your arm and forearm would go almost immediately after the compression is relieved but your neck pain and stiffness may take few days to go off completely.

When do I have to come back post surgery?

Usually you have to come after 2 weeks post surgery for stitch removal. Though you are required to see the surgeon if any of the below mentioned symptoms may occur-

• Fever
• Any inflammatory signs such as redness, swelling etc.
• Any drainage or blood oozing from incision site.
• Severe pain.
• Any numbness or tingling.

What are the restrictions that I need to take following surgery?

• Restriction from bending or twisting the neck for the first six weeks following surgery.
• Proper wound care; keep the wound dry and clean.
• Advice to wear a collar for better healing.
• Advised not to lift heavy objects for 12 weeks following the surgery.

Can I have bath after going back home?

No, not till the stitches are removed.

Do I need Post operative Rehabilitation or therapy?

Yes you need to under go physical therapy under a trained physical therapist initially. The therapist will make you-

• Perform the activities of daily living, for ex. lying to sitting; to stand.
• General conditioning exercises.
• Deep breathing exercises.
• Gentle stretching exercises.
• Understand the proper postural stability.

Can I drive after surgery?

Patients should not drive until they are given approval by their doctor. Normally you can drive 4-wheeler after 1 month of surgery. Two wheelers need to be avoided strictly.

When can I undergo the surgery?

When you are mentally prepared for surgery, you can call and confirm the same to our team on the following numbers, so as to book the operation theatre and room for you, You will be provided the tentative date for admission and surgery.