Synonyms
Spinal fusion, ventral spondylodesis, dorsal spondylodesis, spinal fusion, spinal fusion surgery, spinal fusion surgery, spinal fusion, segment fusion, back pain, spinal surgery, herniated disc
Introduction
The standard procedure for herniated discs of the cervical spine or vertebral body fractures of the cervical spine is ventral spondylodesis (stiffening surgery). Here, the surgical access is chosen from the front (ventral). The vertebral body is stabilized with screws and plates. This is followed by the insertion of a bone chip from the iliac crest or the insertion of bone cement to bridge the defect. Since a spondylodesis always means stiffening of the affected vertebral segment, the indication for surgery should be determined precisely.
Indication
In the case of vertebral body fractures or a herniated disc in the cervical spine area, surgical therapy in the form of ventral spondylodesis may be considered. If there are no neurological deficits or therapy-resistant pain, a conservative therapy without surgery can be considered first. If the conservative therapy does not result in a cure, neurological deficits occur, or if the pain is too severe, surgical therapy is initiated.
Surgical procedures
The operation is performed by default via an access from the front (ventral), i.e. the patient is positioned in a supine position. First, a skin incision is made in the middle of the large muscle of the neck and cervical area (sternocleidomastoid muscle). The soft tissues of the neck are split and the nerves and vessels are spared.
Subsequently, the relevant intervertebral disc and bone appendages are removed. If there is a fracture, it must be located and reduced. In the case of a herniated disc, the space between the two vertebral bodies is then filled with bone from the iliac crest, or with bone cement.
In case of a fracture, the vertebral body is stabilized with the help of an H-shaped plate. After the spinal cord and nerve roots are exposed again, the wound can be closed. Usually a drainage is inserted beforehand, which drains the wound secretion to the outside for two days. Then the surgical field is closed in layers.
