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I was very relieved to wake up after a neck fusion without any hoarseness or loss of voice. They warned me many times that this could happen. I guess I'm wondering how I lucked out?
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Luck may have something to do with it, but certainly, your surgeon's skill and expertise had a large part in the results. Most likely you had an anterior (from the front) fusion. The risk of hoarseness, loss of voice, and dysphagia (difficulty swallowing) are greater with the anterior approach.
That's because the anesthesiologist places a tube down your throat to keep your trachea (airway) open during the surgery. There can also be laryngeal (vocal cords and voice box) spasm or swelling that contribute to the problem.
There are delicate nerves in the throat that control the voice and swallowing. During lower cervical spine fusions, such as at the C6 level or lower, the surgeon must watch out for the recurrent layngeal nerve (RLN). The RLN is located along the right side of the neck. It splits into two parts and loops and travels in several directions. The surgeon must find this nerve and carefully avoid cutting into it by mistake.
All things considered, it's good news that you've been spared this particular complication of anterior cervical spine fusion.
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