C1-C2 Fusion
C1-2 fusion is the procedure in which the 1st and 2nd bone of cervical spine is fused to each other. C1-2 fusion is done when there is instability of the C1-2 bone (atlanto-axial instability) due to inflammatory arthritis like rheumatoid arthritis, trauma, tumors or infection
Operative technique
Anaesthesia: The surgery is performed under general anaesthesia with the patient lying face down on the operating table.
Surgery: After cleaning the area of surgery thoroughly, the level of surgery is confirmed under X ray machine. A incision is made of about 5-6 cm at the level of surgery. Muscles are retracted to one side by dissection to expose the C1 and C2. The landmarks are marked for insertion of the screws in C1 and C2. The correct position of screws is checked under X ray machine. The portion of bone is removed (laminectomy) along with the ligaments to enter into the spinal canal and expose the spinal cord and achieve decompression of the spinal cord. The screws are connected with rods and pieces of bone are inserted along the rods to achieve fusion and gain stability of the spine.
After Surgery
In the recovery room: Immediately after surgery the patient is shifted to recovery room, where the patient is monitored for some time. Medications are provided for pain to control post operative pain relief. Once the patient is comfortable the patient is shifted to ward. A hard cervical collar is given for support and reduce muscular spasm.
In the ward: The patient is allowed to have liquids 6 hours after the surgery. Once the pain has reduced and the patient is comfortable, patient is allowed to sit and walk on the same day or next day of the surgery. The patient is discharged 3-4 days after surgery.
After Discharge:
- It is necessary to stay active after surgery and patient can walk as per his comfort with in his home or nearby.
- The patient should follow healthy eating habits avoid weight gain and obese patient should try to reduce weight.
- The patient should refrain from smoking cigarettes, chewing tobacco and drinking alcohol as these can lead to recurrence of symptoms later.
- Patient should do exercise atleast for 45 mins to 1 hour daily to get good result after spine surgery and avoid future spine related problems.
- The hard cervical collar is worn for 3-4 weeks after which strengthening exercise is started for neck muscles.