Posterior Cervical Fusion (PCF)

A posterior cervical fusion is a surgical technique repairing the cervical spine using a posterior (back of the neck) approach. The PCF is most commonly performed on patients with cervical fractures or significant instability. It can also be performed for spinal tumors, infections, or deformity. PCF may also be used in conjunction with the anterior cervical surgery, especially when multiples levels of the cervical spine are involved.


Procedure

Patients are positioned in the prone (lying on the stomach) position, generally using a special operating table/bed with special padding and supports. The surgical region (neck area) is cleansed with a special cleaning solution. Sterile drapes are placed, and the surgical team wears sterile surgical attire such as gowns and gloves to maintain a bacteria-free environment.

A 3-6 inch (depending on the number of levels) posterior (back of the neck) longitudinal incision is made in the midline, directly over the involved spinal level(s). The fascia and muscle is gently divided, exposing the spinous processes and spine bones. An x-ray is obtained to confirm the appropriate spinal levels to be fused. A laminectomy (removal of lamina portion of bone) and foraminotomy (removal of bone spurs near where the nerve comes through the hole of the spine bone) can be performed if necessary. Two small metal screws can be affixed to each spine bone, one on each side, which are then connected together with a titanium metal rod on each side of the spine. The bony surfaces and facet joints are then decorticated and bone graft is placed, which mends together over time (weeks and months).

The wound area is usually washed out with sterile water containing antibiotics. The deep fascial layer and subcutaneous layers are closed with strong sutures. The skin can usually be closed using sutures or staples. A sterile bandage is applied.

The total surgery time is approximately 2-4 hours, depending on the number of spinal levels involved.