I'm going to have a cervical fusion at the C2-3 level. I've been reading up on the dangers involved with this procedure. Is there anything I can do ahead of time to prevent these possible problems?

There are always risks with any surgical procedure. Some can be reduced and even eliminated with careful surgical planning. Others are nonmodifiable (age, diabetes, heart disease).

In the case of upper cervical fusion, there are several unique risk factors. Some of these may not apply to you. It depends on the type of fixation used. For example, pedicle screws have become a popular fusion technique.

These screws provide high biomechanical strength at the site of fixation. They are inserted through the column of bone called the pedicle along the back of the vertebrae.

In many patients with rheumatoid arthritis of the cervical spine, the pedicles are very narrow. And in 80 per cent of the patients, the vertebral artery supplying blood to the brain is located next to the pedicle at this level. If the screw goes through a thin pedicle, it could penetrate the artery. These are things that your surgeon will address though you may want to discuss them ahead of time.

On a more practical level, if you smoke or use tobacco products, reduce or stop using them as soon as possible before surgery. Tobacco is a known risk factor for poor wound and bone healing. If you are overweight, focus on good nutrition and exercise before surgery. Consult with your physician, physician's assistant, or surgical nurse for any other suggestions that might fit your situation best.