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When conservative measures fail to alleviate herniated or pinched nerves in the neck, cervical spinal surgery may be recommended as an option for relief. But if pain continues postoperatively, this could indicate either that an effective spinal fusion did not take place or there has been recurrent nerve compression.
Failure of neck surgery symptoms includes pain in the neck, numbness, difficulty swallowing and mobility loss. Sometimes these signs can be identified using flexion/extension neck x-rays.
Symptoms of Failed Cervical Fusion
Failed cervical fusion occurs when the expected results of the surgery aren’t achieved, and symptoms persist. Indications of this condition include:
– Long-term chronic pain exceeding 12 weeks
– Dull or sharp localized pain post-surgery
– Neuropathic pain due to nerve damage
– Neck pain, numbness, tingling, weakness, limited motion
– Recurrent disc issues in adjacent areas
– Ongoing spinal stenosis pressure
– Hardware instability or loosening
– Scar tissue formation
– Neurological deficits
Note that some neck discomfort, tenderness, and swelling are normal after fusion, but persistent or worsening pain may signal failure.
If you have signs of failed cervical fusion, consult your healthcare provider for proper evaluation and treatment options.
Pain
For many with neck pain due to herniated discs or spinal cord compression, cervical fusion surgery may be their last resort for relief. This process removes and replaces painful intervertebral discs with bone graft from their pelvis – metal plates or pins may be added for additional support and stability.
Problematic with cervical neck fusion is that it restricts neck mobility and transfers excessive pressure onto vertebrae above and below it – leading to discomfort and degenerative changes within those segments.
Cervical fusion failure typically presents itself in the form of neck pain, particularly radicular symptoms that radiate down your arm. This indicates that the spine is not decompressing as expected and needs decompressing properly for recovery to take place.
Numbness
Surgery to fuse cervical vertebrae may result in various musculoskeletal symptoms. These might include new-onset neck, arm/hand and shoulder pain (radicular pain) as well as myelopathy symptoms such as tingling/numbness in feet/legs.
Subchondral pseudoarthrosis is a major risk associated with spinal fusion that results from when bones fail to fuse correctly during surgery, typically due to an error during procedure; for instance, puncturing of the dura may release spinal fluid through dural leakage and cause it to seep into nerve roots that exit the spine or even result in spinal cord compression – both serious complication that need additional surgical intervention to address.
Tingling
Pain that persists post-cervical fusion surgery could indicate it was ineffective. Signs could include neck discomfort radiating into shoulders and arms/hands as well as tingling sensations in those areas and weakness in these regions.
To remedy the situation, a physician might suggest performing another cervical fusion procedure that unites more segments. This can be accomplished surgically or using additional bone grafts and hardware for maximum spinal stability.
Complications associated with cervical fusion surgery could include swallowing issues and difficulty breathing that compromise calorie intake while slowing bone healing; so your doctor might conduct an in-depth physical and neurological exam in order to evaluate these symptoms and implement proper interventions accordingly.
Loss of Appetite
Patients undergoing cervical spinal fusion often understand that they may not achieve 100% improvement from surgery, though they can manage pain with medication and hope their neck will recover over time.
ACDF (anterior cervical discectomy and fusion) surgery is an operative process designed to extract herniated cervical discs which are compressing nerves or placing pressure on the spinal cord, often leading to compression syndrome or adjacent segment disease in patients postoperatively.
Failure of bone fusion occurs when it fails to heal properly or when bones cannot join together properly, due to factors like unhealed tissue, excessive motion across the fusion site, infection and suboptimal alignment and instrumentation.
Loss of Mobility
The cervical spine can develop numerous pathologies that cause discomfort in the neck, arms and shoulders. Some conditions require surgery to stabilize and limit instability as well as severe deformity or neurologic compromise of this region of spine.
Fusion of one segment of the neck to limit spinal movement transfers movement loads to adjacent segments above and below it, eventually leading to tightness, increased degeneration and new symptoms arising over time.
Fatigue
Fatigue may be an indicator that cervical spinal surgery has not gone according to plan or has caused complications, including herniated discs, spinal degeneration and more.
A cervical fusion may be performed to limit neck motion and protect nerves from being pinched by vertebrae, however its purpose can also shift onto vertebrae below and above the fusion point, potentially shifting neck movement onto them as well.
This can cause instability that leads to similar issues as before their cervical spine surgery – herniated discs and compression of the spinal cord being among them.
What Are the Causes of Failed Cervical Fusion
Failed cervical fusion can stem from patient-related risks and post-surgery complications. Common causes include:
- Patient factors: Low bone density (osteoporosis), chronic steroid use, smoking, diabetes, and poor nutrition.
- Surgery-related complications: Recurrent disc herniation, adjacent level disc breakdown, proximal junctional kyphosis.
- Incomplete symptom relief, failed bone graft healing, temporary or persistent neurological issues.
- Factors affecting cervical spine stability: Scar tissue, pressure from spinal stenosis, hardware instability.
- Rapid bone spur formation, adjacent segment disease, neck pain due to fusion.
Note that some neck discomfort post-surgery is normal. Persistent or worsening pain might signal fusion failure.
If signs of failed cervical fusion arise, consult a healthcare provider for assessment and treatment recommendations.
How Is Failed Cervical Fusion Diagnosed
Detecting failed cervical fusion involves evaluating patients, conducting medical imaging, and clinically assessing the condition. Common diagnostic approaches include:
Patient Evaluation: Physicians perform thorough exams, scrutinize medical histories, and gather information about symptoms, surgical history, and movement restrictions.
Imaging Studies: Various imaging techniques deliver detailed insights into the cervical spine’s condition. These include:
- X-rays: Visualize vertebrae alignment, hardware presence, and signs of instability or non-union.
- Computed Tomography (CT) Scans: Produce cross-sectional cervical spine images, revealing bone structures, fusion details, and complications.
- Magnetic Resonance Imaging (MRI): Uncover soft tissue anomalies, such as disc herniation or nerve compression, potentially linked to failed fusion.
- Bone Scans: Identify heightened bone activity areas, signaling instability or non-union.
Clinical Assessment: Physicians analyze symptoms, physical exam results, and imaging data to pinpoint the diagnosis. They gauge neck and upper extremity movement, muscle strength, and neurological function.
It’s worth noting that failed cervical fusion has diverse triggers, encompassing surgical, patient, and complication-related factors, like non-union or pseudarthrosis.
Hence, a comprehensive evaluation becomes crucial to identify the root cause and design a fitting treatment plan. If a failed cervical fusion is suspected, seeking guidance from a qualified healthcare professional is advisable for accurate diagnosis and personalized treatment strategies.
What Are the Treatment Options for Failed Cervical Fusion
Treatment choices for failed cervical fusion hinge on cause and symptom intensity. Common options include:
- Physical Therapy: Eases pain, enhances mobility, and strengthens cervical spine muscles.
- Revision Surgery: Required if initial fusion didn’t heal or issues like hardware failure or nerve compression arose. Specific revision surgery type varies based on failed fusion cause—decompression, laminectomy, microdiscectomy, or revision fusion.
- Conservative Approach: For asymptomatic patients with solitary pseudarthrosis, conservative management is preferred—pain control, physical therapy, symptom monitoring.
- Bone Graft or Substitute: When non-union or pseudarthrosis caused the failed fusion, bone graft or substitute can spur bone growth and fusion.
Remember, optimal treatment hinges on the patient’s needs and failed fusion’s cause. Consulting a healthcare professional ensures accurate diagnosis and tailored treatment advice.
