Life After Three Level Cervical Fusion Surgery. Tips on How to Prevent Complications

life after multilevel cervical fusion surgery

How is life after three level cervical fusion surgery? This is the most common question after three-level cervical fusion surgery. People with their back and neck issues deserve to get better, get their life back, and get back to work. In an attempt to bring these individuals back into their full-speed lives again, doctors and other spine treatment providers focus on mitigating pain. Adequate fitness and conservative treatment are typically all that is required. Occasionally, surgery to regain full function can be needed.

Spine surgery produced a well-deserved stigma years ago for causing as much back pain as it helped. Surgery has rarely given as much profit as it was wished for. Progress in our ability to detect and cure spinal injury has improved significantly over the last twenty years of my career.

It is normal to think about how well your neck will bend after the surgery if you consider an anterior cervical discectomy with fusion (ACDF) operation for neck pain. Overall, it will solidly fuse one or more of your neck’s mobile joints and cease to move. And how can that impact the quality of life? Fortunately, ACDF patients, both in pain relief and quality of life following the operation, usually have positive success. 

Three Things to Remember About Neck Mobility After Three Leval Cervical Fusion Surgery

The Overall Range of Motion Is Minimally Influenced 

The total range of motion of your neck after ACDF is expected to be close to what it was before unless the surgeon states it differently. The other vertebrae appear to rotate freely when the adjacent vertebrae are solidly bonded and no longer move. They may even move further to compensate for some of the missed motion. Many ACDF operations are also carried out in the lower cervical spine, less mobile, and less required than the upper cervical spine for simple neck movements.

The Total Range of Motion Is Often Expanded

It may sound counterintuitive, but often, relative to pre-surgery measurements, a single-level ACDF may result in an improvement in the total range of motion of the spine. In cases where pre-surgery pain levels reduce the range of motion of the spine, this can occur, but lowered pain levels following surgery help regain mobility.

Many Movements Use Just a Portion of the Range of Motion of the Neck

Except when three or four stages of the lower cervical spine are combined, approximately 75 percent of the total range of motion of the neck remains.2 This is more than enough versatility to perform everyday activities, which appear to need just 30 percent to 50 percent of the neck’s range of motion.3 Strategies can be learned to accommodate in extreme cases where more neck mobility is required.

What Happens After a Three Level Cervical Fusion Surgery?

life after multilevel cervical fusion surgery

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In the sense that it usually involves decompressing the spine (removing some fluid or structure that inflames a spinal nerve or spinal cord) and then stabilizing the spine, a multilevel fusion is equivalent to a single-level fusion. The critical distinction is that at least two cervical stages would be involved in a multilevel fusion instead of one. The patient must be prepared for life after multilevel cervical fusion surgery.

Why Multilevel Cervical Fusion Impacts Neck Mobility in General?

Any experiments have shown that a substantial mobility range may be lost after a neck fusion has reached three or four cervical stages. One small study showed that, relative to their preoperative cervical ranges of motion, a group of patients with three or four-level cervical fusions had lost an average of:

  • More than 25 per cent of (forward/backward) extension/flexion
  • About 25 percent of lateral bending (side to side)
  • Roughly 14% of the rotation (turning left and right)

However, even with these reported declines in general mobility of the spine, much of the everyday activities may not have been impaired. It is rare for an operation during the day to require more than 30 percent to 50 percent of the total range of motion of a healthy cervical spine.

While individuals with a three- or four-level cervical fusion may execute most everyday activities without being impeded by a decreased cervical range of motion, they may also have an adjustment phase, and new methods of management will be needed for specific tasks.

People may take their everyday grooming routine for granted, but these activities may require a more excellent range of motion throughout the cervix than most activities usually performed during a day. For example, after a multilevel fusion, washing hair, shaving, and applying make-up will all entail lots of neck motions and may take some changes.

Muscle Pain After Three Level Cervical Fusion Surgery

life after multilevel cervical fusion surgery

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A Three-Level Cervical Fusion is a major operation that removes three disks and places hardware to support the spine. The process is conducted in a hospital, which takes several hours to finish. It is essential to understand what happens to your life after three-level cervical fusion surgery.

Surgery for cervical fusion is joint. There are also different kinds of surgery for cervical fusion. Centered on the surgical method, they can be classified into two main groups.

The Anterior (FRONT)

The disks are inserted by the surgeon by an incision in the front of the skull. Discus removal is termed a discectomy. At the front of the collar, the screws and plates are located. This method of surgery is generally known as ACDFF (Anterior Cervical Discectomy and Fusion)

Posterior to (BACK)

The surgeon separates the disks through an incision in the back of the neck during a posterior fusion. At the end of the spine, the screws and plates are mounted. This form of action is usually referred to as a PCFF (Posterior Cervical Fusion). In addition to the disc, called the lamina, this method includes eliminating essential spinal bones. The lamina provides the spinal cord with crucial support and security.

After Surgery

The added complications and the surgical procedure choices for three-level fusions were performed for degenerative disc disease and low back pain to reduce damage and improve the chances of symptom relief and complete recovery. A fusion of three or more spine layers is rarely, if ever, advisable for painful multilevel degenerative disc disease. Extreme care should be practiced for patients exploring this option by proactively investigating all their non-surgical alternatives and finding additional surgical and non-surgical advice.

Swallowing Trouble

Swallowing difficulty is termed dysphagia, which can occur after fusion of the jaw. In one study, the rate of dysphagia was 12.7 percent following Cervical Fusion Surgery. Swallowing problems can compromise calories, fluid consumption, and recovery.

Failed Merger

Failure to fuse the bones is known as non-union or pseudoarthrosis. This suggests that the implanted screws and plates, the lengthy healing, and the bones’ discomfort did not reconnect after the surgery. The expected surgery has failed, and weakness in the neck is now present. The rate of non-union is striking, and 52 percent was observed in one report.

Neck Pain Continued

Some patients appear to have persistent neck pain that involves oral medicine, despite the Three-Level Fusion. Just 39 percent of patients could return to function in a new study after one year of neck fusion—the risk of complications rises. A Three-Level Fusion is associated with a greater rate of loss and complications than a Two-Level Cervical Fusion.

The leak in Spinal Fluid (CSF)

The outermost membrane protecting the brain and spinal cord is the Dura. During the procedure, this central layer may be punctured, creating a leak in spinal fluid. A typical symptom of Dural Leak is an extreme headache. A spinal fluid leak can lead to infection if left untreated.

Life After Cervical Fusion Surgery, What Happens?

life after multilevel cervical fusion surgery

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Monitoring can be performed with blood pressure, pulse rate, and respiration. Any distress will be handled. When you are awake, you will be transferred to a standard room where your operation level will increase (sitting in a chair, walking). Patients who have had a bone graft removed from their hip may experience more significant pain than a neck incision in their hip. Many patients with an ACDF rating of 1 or 2 are sent home on the same day. You can need to wait overnight, however, whether you have trouble breathing or unstable blood pressure.

Pain is treated with narcotic drugs following surgery. These are prescribed for a short amount of time, and narcotic painkillers are addictive (2 to 4 weeks). 

Drink plenty of water and eat high-fiber foods, as their daily use can induce constipation. Laxatives may be obtained without a prescription (e.g., Dulcolax, Senokot, Milk of Magnesia). The discomfort is then treated with acetaminophen.

In individual patients, hoarseness, sore throat, or trouble swallowing can occur, which should not be a cause for concern. They usually relieve these effects within 1 to 4 weeks.

Restrictions

  • Must not take non-steroidal anti-inflammatory medications (NSAIDs) (e.g., aspirin, ibuprofen, Advil, Motrin, Nuprin, sodium naproxen, Aleve) for six months following surgery if you have had a fusion. NSAIDs can contribute to bleeding and interfere with the healing of bones.
  • You should not smoke. By increasing the risk of complications (e.g., infection), smoking slows healing and reduces bones’ ability to fuse.
  • Do not travel for 2 to 4 weeks after surgery or until the specialist has spoken to you.
  • Do not keep sitting for long periods.
  • Stop leaning forward or backward with your head.
  • Heavier than 5 pounds, do not lift something (e.g., a gallon of milk).
  • Before the first follow-up office visit, housework and yard-work are not allowed. This includes the dishwasher, washer, or dryer for planting, mowing, vacuuming, ironing, and loading/unloading.
  • Unless otherwise stated by your physician, delay sexual intercourse until your follow-up date.

Also Read: How to Sleep After Gallbladder Surgery?

Activity After Surgery

life after multilevel cervical fusion surgery

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  • For everyday operations (e.g., dressing, bathing), you can need support, but most patients can quickly take care of themselves.
  • Adjust to your daily activities steadily. It is recommended to walk; begin with a short distance and rise steadily to 1 to 2 miles every day. A curriculum for physical therapy may be recommended.
  • Know how to wear a cervical collar if necessary before visiting the hospital. Wear it in a car while driving or running.

Prevention and Recovery

During operation, make a follow-up consultation with the surgeon for two weeks. Generally, the healing period lasts 4 to 6 weeks. X-rays can be obtained to check the occurrence of fusion for several weeks. In a follow-up appointment, the surgeon will decide whether to release you back to work.

During healing, a cervical collar or brace is often worn to protect and restrict mobility as the neck recovers or fuses (see Braces & Orthotics). After your neck has healed, your doctor can recommend neck stretches and exercises or physical therapy. You may feel discomfort, soreness, and weakness in the incision if you have had a bone graft removed from your hip. 

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