Posterior Cervical Fusion
A clear, evidence-based medical guide to posterior cervical decompression: when it is recommended, what it involves, and what to expect after surgery.
Posterior incision and access
Decompression + stabilization
General anesthesia
Often 1–3 days (case-dependent)
What is posterior cervical fusion?
This is a cervical spine operation in which the surgeon approaches the spine from the back of the neck. Depending on the underlying condition, the procedure includes decompression (removal of structures compressing nerves or the spinal cord) followed by fusion (stabilization using instrumentation and bone graft), in order to reduce instability and protect neural structures.
In simple terms: when the cervical spine becomes “narrowed” (stenosis) or moves abnormally (instability), surgery aims to relieve pressure on the nerves or spinal cord and to stabilize the affected levels in a safe, individualized manner.
When is it recommended?
Posterior decompression and fusion are recommended when there is compression of the spinal cord and/or nerve roots, with symptoms such as pain, numbness, weakness, gait instability, or progressive functional decline, and when conservative treatment is no longer sufficient.
Common indications
- Cervical stenosis / cervical myelopathy (spinal cord compression)
- Multilevel degenerative disease with neurological symptoms
- Cervical instability (degenerative, traumatic, or postoperative)
- Fractures or injuries requiring stabilization
- Selected cases requiring combined decompression and fusion
When it is reasonable to discuss surgery
- Persistent or progressive neurological symptoms (numbness, weakness, instability)
- Significant impact on quality of life despite treatment
- Imaging correlation (MRI/CT) with clinical symptoms
- Individualized assessment of benefit versus risk
Before surgery
Preparation focuses on maximal safety: confirming the diagnosis, defining clear objectives, completing preoperative evaluation, and planning recovery.
Clinical & neurological assessment
Documentation of symptoms, neurological examination, and discussion of realistic goals.
Imaging (MRI/CT) & level planning
Identification of the levels requiring decompression and stabilization based on anatomy and pathology.
Preoperative testing
Laboratory tests, cardiac/anesthesia evaluation, and medication review.
Discharge planning & support
Arranging home assistance, activity instructions, and possible use of a cervical collar (as indicated).
How is the procedure performed?
The operation is performed under general anesthesia. The surgeon approaches from the back of the neck, completes the necessary decompression, and then stabilizes the spine using instrumentation (screws/rods) and bone graft to achieve fusion.
Positioning & neural protection
Proper patient positioning and careful exposure to ensure safety and precision.
Decompression
Removal of structures compressing the spinal cord or nerve roots, tailored to the pathology.
Stabilization (instrumentation)
Placement of stabilization hardware (e.g., screws and rods) at the selected levels.
Bone graft & closure
Placement of bone graft to achieve fusion and closure aimed at optimal healing.
The exact technique (levels, type of decompression, need for a collar, length of hospitalization) is determined on an individualized basis according to diagnosis, anatomy, and comorbidities.
After surgery: recovery & rehabilitation
Recovery varies depending on the number of levels, the type of decompression, and overall health. Instructions are individualized and adjusted to your progress.
First days
- Pain control and mobilization as early as safely possible
- Neurological monitoring (sensation/strength/gait)
- Gradual return to light activities
- Occasionally, a cervical collar (case-dependent)
At home & return to activity
- Avoid heavy lifting and sudden movements in the early postoperative period
- Gradual increase in activity with guidance
- Physical therapy/exercises when indicated
- Scheduled follow-up and imaging as appropriate
Important: the goal of surgery may be decompression/protection of neural structures and stabilization— complete symptom resolution depends on the chronicity and severity of the underlying condition.
Risks & possible complications
Every surgical procedure carries risk. Our aim is maximal safety through appropriate indication, preparation, and technique. Risks are always discussed on an individualized basis.
Examples include
- Infection
- Bleeding / hematoma
- Swelling
- Neurological deficit (rare, depending on anatomy and pathology)
- Cerebrospinal fluid (CSF) leak
- Wound-related complications
- Thrombosis
- Anesthesia-related complications
- Non-union/pseudarthrosis or need for reoperation in selected cases
- Instrumentation failure
Risk depends on diagnosis, levels involved, anatomy, and overall health. These factors are discussed individually before a surgical decision is made.
When you should contact us immediately
After discharge, contact our team if you develop symptoms that are new, worsening, or concerning.
Contact us if you experience
- Fever or signs of wound infection
- Severe or worsening pain, or new numbness/weakness
- Difficulty walking, worsening balance, or new neurological symptoms
- Severe headache, confusion, or unusual drowsiness
- Shortness of breath, chest pain, or leg swelling
Frequently Asked Questions (FAQ)
Concise, practical answers to questions we commonly hear in clinical practice.
How long does the operation take?
Duration depends primarily on the number of levels and the type of decompression/stabilization. It typically ranges from a few hours and is determined individually.
How many days of hospitalization are required?
Often 1–3 days, depending on pain control, mobilization, and associated conditions.
Will I need a cervical collar?
In some cases a collar is used for a period, but it is not required for everyone. The decision depends on stabilization, number of levels, and bone quality.
When can I drive or return to work?
Typically after the initial recovery phase and once movements and pain are safely controlled (especially without strong analgesics). Return to work depends on the type of job and is usually gradual with guidance.
Will I lose neck mobility?
Fusion limits motion at the stabilized levels. Overall mobility depends on the number of levels and the pre-existing condition. The priority is protection of neural structures and stability, not “maximal motion at any cost.”
When is follow-up imaging required?
Follow-up (clinical and/or imaging) is scheduled by the surgeon based on the procedure, instrumentation, and your recovery.
Consultation with a specialized spine team
If you have been advised to undergo posterior cervical decompression and fusion or are seeking a second opinion, our team can review your history and imaging and discuss a safe, individualized treatment plan.