C1-C2 Fusion
What is C1-C2 Fusion ?
C1-C2 fusion is a surgical procedure performed to stabilize the first (C1 or atlas) and second (C2 or axis) cervical vertebrae. This fusion is necessary when there is instability or excessive movement between these vertebrae, which can lead to pain, neurological symptoms, or even life-threatening complications due to spinal cord compression.
The procedure involves securing the vertebrae with screws, rods, and bone grafts to promote fusion, preventing excessive movement that could compress the spinal cord. Performed through a posterior approach, the surgery aims to relieve pain, restore stability, and protect neurological function.Most patients experience significant improvement in symptoms and return to normal activities within a few months.
Indications for C1-C2 Fusion
C1-C2 fusion may be required for conditions such as:
- Trauma/Injury: Fractures of the odontoid process (dens) or ligament injuries.
- Rheumatoid Arthritis: Atlantoaxial instability due to chronic inflammation.
- Congenital Abnormalities: Conditions like Down syndrome or Klippel-Feil syndrome.
- Degenerative Diseases: Severe arthritis affecting the C1-C2 joint.
- Tumors or Infections: Affecting the cervical spine.
Surgical Procedure
- Preoperative Imaging: X-rays, CT scans, and MRIs to assess instability.
- Anesthesia: The patient is under general anesthesia.
- Surgical Approach:
- A posterior (back of the neck) approach is commonly used.
- The surgeon places screws into C1 and C2 vertebrae to secure stability.
- Bone grafts (autograft from the patient’s bone or allograft from a donor) are used to promote fusion.
- Rods or plates may be placed to reinforce the fixation.
- Closure & Recovery: The incision is closed, and the patient is monitored closely post-surgery.
Recovery & Rehabilitation
- Hospital Stay: Typically 2–5 days.
- Neck Brace: May be required for several weeks for additional support.
- Pain Management: Medications for pain and inflammation.
- Physical Therapy: Gradual reintroduction of movement to strengthen the neck.
- Healing Time: Bone fusion typically takes 3–6 months.
Risks & Complications
- Infection
- Nerve or spinal cord injury
- Non-union (failure of bones to fuse)
- Hardware failure
- Reduced range of motion in the neck