Posterior cervical fusion approaches the cervical spine from the back of the neck to decompress the spinal cord and stabilize multiple vertebral levels with screws and rods. It is used for conditions where the anterior approach is not sufficient — including multilevel cervical stenosis with myelopathy, cervical instability, deformity, and cases where posterior bone anatomy needs to be directly addressed.
What Is Posterior Cervical Fusion?
The posterior cervical spine is accessed through an incision at the back of the neck, allowing Dr. Chavarria direct visualization of the laminae, facet joints, and nerve roots. Depending on the indication, the procedure may involve laminectomy (removal of the posterior bone arch to expand the spinal canal), laminoplasty (hinged opening of the laminae without full removal), or decompressive foraminotomy (opening the bony tunnels through which nerve roots exit). When decompression alone is insufficient or when the spine is unstable, lateral mass screws and rods are placed to fuse the involved levels.
Posterior cervical fusion is particularly valuable for multilevel cervical spondylotic myelopathy — compression of the spinal cord by bone spurs and thickened ligament across three, four, or more levels. In these cases, an anterior approach would require a high-risk multilevel reconstruction, whereas a posterior approach can decompress all affected levels through a single incision. It is also the approach of choice for cervical trauma, rheumatoid instability, and correction of cervical kyphotic deformity.
Modern posterior cervical instrumentation uses polyaxial lateral mass screws placed into the posterior aspect of the cervical vertebrae, connected by titanium rods. Pedicle screws may be used in the lower cervical and upper thoracic spine for stronger fixation. Bone graft is placed along the fusion levels to promote solid arthrodesis over 3–6 months.
Are You a Candidate?
- Patients with multilevel cervical stenosis causing spinal cord compression (myelopathy) — difficulty with hand coordination, gait instability, or upper extremity weakness across multiple levels
- Patients with cervical instability from trauma, rheumatoid arthritis, or prior surgery requiring posterior stabilization
- Patients with cervical kyphotic deformity requiring realignment from a posterior approach
- Patients who have had a prior ACDF and developed adjacent segment disease or pseudarthrosis requiring extension of the fusion posteriorly
- Patients with multilevel cervical radiculopathy amenable to posterior foraminotomy without fusion
- Patients for whom an anterior multilevel reconstruction would carry excessive risk
What to Expect
Pre-operative: MRI defines the levels of cord compression and signal change within the cord (a marker of severity). CT defines bony anatomy for screw placement planning. Neurological examination is documented in detail. Pre-operative optimization including neck range of motion assessment is completed.
Day of surgery: The procedure is performed under general anesthesia with neuromonitoring (SSEP and MEP) to protect the spinal cord throughout. Surgery takes 2–5 hours depending on levels. A 1–3 night hospital stay is typical. You will work with physical therapy during your inpatient stay.
First 4 weeks: A cervical collar is worn for comfort and protection for 2–6 weeks. You are walking and performing light activities. Significant improvement in myelopathic symptoms (weakness, coordination) may be gradual — nerve recovery can continue for months to over a year depending on the severity and duration of cord compression prior to surgery.
3–12 months: Serial X-rays confirm fusion progression. Physical therapy for cervical strengthening and balance begins at 6–8 weeks. Most patients experience meaningful improvement in walking stability, hand function, and arm symptoms, though complete reversal of myelopathy depends on how long the cord was compressed before decompression.
Why Choose Dr. Chavarria for Your Posterior Cervical Fusion in Reno?
- Decompresses multiple cervical levels through a single posterior incision
- Avoids the risks of multilevel anterior reconstruction at 3+ levels
- Pedicle and lateral mass screw fixation provides robust, immediate stability
- Neuromonitoring throughout surgery provides real-time spinal cord safety feedback
- Addresses both cord compression and cervical instability in a single procedure
- Effective for myelopathy — improves function and prevents further neurological deterioration