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I've been putting it off and putting it off but I'm finally ready to have a neck fusion. It looks like they will have to remove some of the bone around the nerves and then fuse the spine at three levels. Are there any times when this operation just shouldn't be done? Am I one of those cases?

Your surgeon would not advise you to have this surgery is you weren't a good candidate for it. But it's always best to go into an operation with a clear mind and a positive outlook. So perhaps before you make that final decision, ask your surgeon to explain what will be done, how it will be done, and why you are a good patient for that procedure.

There are many different ways to decompress the spinal cord. The surgeon will be planning all the details of what approach to take, what kind of incision to make, what materials to use to fuse the spine, and so on.

In all cases, the goal is to take pressure off the nerve tissue, reduce your pain, and stabilize the neck. The surgeon will also be concerned about preventing any complications or problems during and after the operation.

Studies show that there are what are called prognotic indicators for who should or shouldn't have this operation.

Reasons to have the procedure done include:

  • neurologic signs and symptoms are getting worse instead of better
  • the problem has been going on for six months or more
  • pressure on the spinal cord indicates necessity

    Reasons not to have the operation can include:

  • very poor health
  • older age (70 years old and older)
    diabetes with poor wound healing
  • heart disease and/or poor circulation
  • history of a stroke
  • chronic use of tobacco or alcohol (delays wound healing)

    Talk to your doctor if any one or more of these factors describes you. It's likely he or she has already taken everything into account in making the final decision. With a little more education, you will feel more confident in your chosen treatment intervention.

    • Reference: 

    Ricardo J. Komotar, MD, et al. Surgical Management of Cervical Myelopathy: Indications and Techniques for Laminectomy and Fusion. In The Spine Journal. November/December 2006. Vol. 6. No. 6S. Pp. 252S-267S.

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