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Cervical Fusion (ACDF) in India

Surgical procedure to fuse cervical vertebrae and relieve nerve compression in the neck

Overview

Cervical Fusion, also known as Anterior Cervical Discectomy and Fusion (ACDF), is a highly successful surgical procedure designed to treat cervical disc herniation, degenerative disc disease, spinal stenosis, cervical radiculopathy, and neck instability by removing the damaged disc and fusing the adjacent vertebrae together. This procedure eliminates painful motion between vertebrae, relieves pressure on nerve roots and the spinal cord, and restores proper alignment and stability to the cervical spine. At Arthoscenter in Patna, Bihar, Dr. Gurudeo Kumar has established himself as one of the region's leading spine surgeons, having performed over 800 successful cervical fusion procedures with exceptional clinical outcomes and patient satisfaction rates exceeding 92%. Our advanced spine surgery center utilizes state-of-the-art microscopic and endoscopic techniques, computer-assisted navigation systems, high-quality titanium cage implants with bone graft material, and minimally invasive approaches to ensure precise decompression, optimal fusion rates, and faster recovery for every patient. The cervical spine consists of seven vertebrae (C1-C7) that support the head, protect the spinal cord, and allow for a wide range of neck motion. Between each vertebra are intervertebral discs that act as shock absorbers and facilitate smooth movement. When these discs degenerate, herniate, or compress neural structures, patients experience debilitating neck pain, radiating arm pain (cervical radiculopathy), numbness, tingling, weakness in the hands and arms, difficulty with fine motor tasks, and in severe cases, difficulty walking or maintaining balance due to spinal cord compression (cervical myelopathy). Cervical fusion addresses these conditions by removing the damaged disc material that is compressing the nerves or spinal cord (discectomy), thoroughly decompressing all neural structures, inserting a bone graft or cage spacer to maintain proper disc height and restore normal spine alignment, and using a titanium plate with screws to stabilize the segment while the bone fusion occurs over 3-6 months. This creates a solid bridge of bone between the vertebrae, eliminating the painful motion at that segment while maintaining stability and function of the cervical spine. The ACDF procedure is typically performed through a small incision in the front of the neck, allowing the surgeon to access the cervical spine without disturbing the spinal muscles, which significantly reduces postoperative pain and accelerates recovery compared to posterior approaches. Dr. Kumar utilizes advanced surgical microscopes and specialized retractors to carefully move aside vital structures including the carotid artery, jugular vein, esophagus, and trachea, providing excellent visualization of the disc space and neural elements. Success rates for cervical fusion surgery are excellent, with 85-95% of patients experiencing significant improvement in arm pain and neurological symptoms within the first few weeks after surgery. Neck pain improvement may be more gradual but is typically substantial by 3-6 months post-surgery. The fusion success rate at our center exceeds 95%, meaning the vertebrae successfully grow together to form a solid bone bridge in the vast majority of patients. Most patients can return to desk work within 2-4 weeks, physical labor within 8-12 weeks, and full unrestricted activities including sports within 4-6 months depending on the extent of fusion and individual healing. At Arthoscenter, we take a comprehensive approach to cervical fusion surgery, beginning with thorough preoperative evaluation including detailed history, physical examination, neurological assessment, and advanced imaging (MRI, CT, flexion-extension X-rays) to precisely identify the source of compression and plan the optimal surgical approach. We provide extensive patient education about the procedure, realistic expectations for recovery, and strategies to optimize outcomes. Our surgical team uses the latest techniques and implants to ensure optimal decompression, restoration of normal cervical alignment, and high fusion rates while minimizing risks and complications.

Symptoms & Indications

This surgery may be recommended if you experience:

Persistent neck pain radiating to shoulders and arms

Numbness, tingling, or weakness in hands and fingers

Arm pain worse than neck pain (radiculopathy)

Difficulty with fine motor tasks (buttoning, writing)

Electric shock-like sensations down the arms

Headaches originating from the neck

Muscle spasms in neck and shoulders

Loss of grip strength and hand dexterity

Difficulty walking or balance problems (myelopathy)

Progressive neurological decline despite conservative treatment

Procedure Details

Duration

2-3 hours for single-level fusion; additional 30-45 minutes per extra level

Anesthesia

General anesthesia with endotracheal intubation and neuromonitoring

Preparation for Surgery

Comprehensive spine evaluation with MRI, CT scan, and X-rays. Neurological examination to assess nerve function. Discussion of fusion levels and implant options. Pre-surgical medical clearance. Smoking cessation at least 4 weeks before surgery (critical for fusion success). Stopping blood thinners as directed. Fasting 8-12 hours before surgery.

Surgical Steps

1

General anesthesia administration and patient positioning supine (on back)

2

Small horizontal skin incision (2-3 cm) made on the front/side of the neck

3

Careful dissection and gentle retraction of vital neck structures (carotid artery, jugular vein, esophagus, trachea)

4

Exposure of the affected cervical disc space using fluoroscopy (live X-ray) guidance

5

Complete removal of the damaged disc (discectomy) using specialized instruments

6

Thorough decompression of nerve roots and spinal cord by removing bone spurs and ligaments

7

Preparation of vertebral endplates and insertion of bone graft or interbody cage filled with bone graft material

8

Placement of anterior titanium plate and screws to stabilize the fusion construct

9

Final fluoroscopic confirmation of proper implant position and alignment

10

Closure of incision in layers with absorbable sutures (minimal scarring)

Recovery Timeline

What to expect during your recovery journey

Hospital Stay (1-2 days)

Initial Recovery

Most patients go home next day. Neck brace may be prescribed. Pain management with medications. Early walking encouraged.

Weeks 1-2

Rest and Gradual Activity

Rest and gradual increase in daily activities. Neck brace worn as directed (if prescribed). Avoid heavy lifting, bending, twisting. Return to light desk work possible.

Weeks 3-6

Progressive Activity & Physical Therapy

Progressive increase in activities. Physical therapy begins to improve neck mobility and strength. Driving permitted when off narcotic pain medications.

Months 2-3

Continued Therapy & Assessment

Continued physical therapy. X-rays to assess early fusion progress. Return to moderate activities and physical work. Bone fusion actively occurring.

Months 4-6

Full Recovery & Return to Activities

Fusion typically complete by 6 months. X-rays or CT scan to confirm solid fusion. Return to unrestricted activities including sports. Long-term success with proper spine care.

Tips for Faster Recovery

Wear neck brace exactly as prescribed (typically 4-6 weeks if used)

Avoid smoking and nicotine products (severely impairs fusion healing)

Take calcium and vitamin D supplements to support bone fusion

Sleep with proper neck support using cervical pillow

Avoid overhead reaching and repetitive neck turning in early recovery

Maintain good posture and ergonomics at work and home

Follow physical therapy program to restore neck strength and mobility

Attend all follow-up appointments for fusion assessment with X-rays

Frequently Asked Questions

Common questions about this procedure

Q1.How successful is cervical fusion surgery?

Cervical fusion has excellent success rates of 85-95% for relieving arm pain and neurological symptoms. The fusion success rate (vertebrae successfully fusing together) exceeds 95% at our center. Most patients experience significant improvement in quality of life and can return to normal activities within 3-6 months. Success is highest when surgery is performed before severe permanent nerve damage occurs.

Q2.Will I lose neck motion after cervical fusion?

There is some loss of motion at the fused segment, but most patients do not notice significant functional limitations. The cervical spine has 7 levels, so if 1-2 levels are fused, the remaining unfused levels compensate well. Single-level fusion typically results in 5-10% total neck motion loss. The trade-off of slight motion loss for elimination of severe pain and neurological symptoms is generally very favorable for patients.

Q3.What is the cost of cervical fusion surgery in Bihar?

At Arthoscenter in Patna, the cost of ACDF surgery ranges from ₹1,80,000 to ₹3,50,000 depending on the number of levels fused, implant type (standard titanium vs. advanced materials), hospital stay duration, and whether additional procedures are needed. This includes surgeon fees, hospital charges, implants, anesthesia, medications, and initial follow-up. We accept most insurance plans and offer flexible payment options. Book your ₹999 consultation to receive a detailed personalized cost estimate.

Q4.How long does it take for the bones to fuse together?

Bone fusion is a biological process that typically takes 3-6 months to complete. Initial bone healing begins within the first few weeks, but solid fusion (confirmed by X-rays or CT scan) usually takes 4-6 months. During this time, it is critical to follow all restrictions, avoid smoking, take calcium and vitamin D supplements, and wear a neck brace if prescribed. Most patients feel much better within the first 6-12 weeks, but complete fusion continues to strengthen over the full 6 months.

Q5.Can I avoid fusion with physical therapy or injections instead?

For many patients with mild to moderate cervical disc disease, conservative treatments including physical therapy, medications, epidural steroid injections, and activity modification can provide adequate relief. However, cervical fusion is recommended when: (1) severe or progressive neurological deficits are present, (2) significant spinal cord compression (myelopathy) exists, (3) conservative treatments have failed after 6-12 weeks, (4) severe instability is present, or (5) quality of life is severely impacted. Dr. Kumar will thoroughly evaluate your condition and only recommend surgery when it offers the best chance for long-term improvement.

Considering This Surgery?

Book an online video consultation with Dr. Gurudeo Kumar for just ₹999 and get all your questions answered