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Cervical spineMinimally invasive surgery

Anterior cervical fusion (interbody fusion with plate)

Anterior cervical fusion (interbody fusion with plate) is considered for patients with neck pain radiating to the arm, tingling or weakness after months of persistent symptoms despite conservative care and imaging showing a degenerated or herniated disc compressing the root or cord. Through a small incision at the front of the neck, the diseased disc and bone spurs are removed, a cage or graft is placed to maintain height and promote fusion, and a plate with screws provides stability. The goal is to relieve nerve compression and reduce painful motion at that segment, with indication always personalised to symptoms and imaging.

Spine neurosurgeon in Alicante and Benidorm
More than 20 years of experience in Neurosurgery (since 2003)
Vithas Medimar Hospital Alicante and Hospital Clínica Benidorm
Medical illustration of anterior cervical fusion with a plate.

What is Anterior cervical fusion (interbody fusion with plate)?

Anterior cervical fusion (interbody fusion with plate) combines decompression of neural structures with stabilisation of the affected segment. Through a small anterior neck approach, the diseased disc and compressive bone are removed and replaced with an interbody cage or graft to maintain height and allow fusion. A plate with screws on the anterior vertebrae reinforces stability. Unlike discectomy without fusion, it provides added stability, useful in markedly degenerated or unstable segments or when multiple levels are treated.

Symptoms and warning signs

In degenerative cervical disease, watch for:

Persistent neck pain, often radiating to the shoulder and arm
Tingling, numbness or “electric shock” sensations in the arm, forearm or fingers
Loss of strength or clumsiness when gripping, opening jars, writing or handling tools
Pain worsened by certain neck positions or effort and partly relieved by rest
Red flags: progressive or sudden loss of strength, difficulty walking, falls, marked sensory changes or bowel/bladder disturbances requiring urgent assessment

When is this procedure indicated?

Persistent neck and/or arm (radicular) pain despite conservative treatment (medication, physiotherapy, posture measures, injections)
MRI or CT showing cervical disc herniation, disc collapse or degenerative changes clearly matching symptoms
Neurological progression: worsening strength, increased fine-motor clumsiness, sensory change or signs of cord involvement
Disabling pain affecting quality of life, sleep and ability to work or perform daily activities
Documented segmental instability where fusion provides stability and reduces painful motion

How is the procedure performed?

1.Preoperative preparation

A full neurological exam and detailed imaging review confirm correlation between symptoms and affected levels. The neurosurgeon explains goals, alternatives, benefits and risks. Fasting instructions are given, medication is adjusted (anticoagulants, antiplatelets and chronic treatments) and medical history is reviewed with anaesthesia before consent.

2.During the procedure

Under general anaesthesia, a small incision on one side of the neck allows gentle separation of tissues to the cervical spine. The diseased disc and compressive osteophytes are removed, the interbody space prepared and a cage or graft inserted to maintain height and promote fusion. A plate with screws is fixed to the treated vertebrae for immediate stability. Intraoperative imaging and a surgical microscope are often used for precision.

3.Immediate postoperative period

After surgery, the patient stays in recovery for monitoring of vital signs, breathing and pain, then returns to the ward. Neck discomfort and a sore throat feeling are common initially. Mobilisation usually starts early, the same day or next, with assistance. Hospital stay is typically 24–48 hours depending on pain control, ability to eat and neurological stability.

Recovery and daily life

Recovery is often relatively quick compared to more extensive spine surgery. In the first days, neck pain, tightness and swallowing discomfort are common and usually improve. Basic activity starts early, avoiding sudden neck movements and heavy lifting. Return to office work is often considered between 2 and 3 weeks; physical or demanding jobs may require 6–8 weeks or more. Targeted physiotherapy, ergonomic advice and gentle exercises help strengthen neck muscles. If fever, marked wound redness, disproportionate pain or new weakness appears, prompt review is needed.

Risks and possible complications

As with any surgery, there are risks. General risks include anaesthesia-related issues, wound infection, bleeding, haematoma and venous thrombosis. Specific risks include nerve root injury or, less commonly, spinal cord injury, partial persistence of symptoms, transient dysphagia, injury to oesophagus, trachea, vessels or recurrent nerve, lack of bone fusion (pseudoarthrosis) and long-term adjacent level degeneration. Some residual neck pain may persist. These risks are weighed against the benefit of decompressing and stabilising the segment in each case.

Frequently asked questions

It usually takes between 60 and 120 minutes depending on how many levels are treated and case complexity. Additional time is needed for operating room preparation and awakening in recovery. The team will outline the expected duration for your case.
You will not feel pain during surgery because it is performed under general anaesthesia. Afterward, neck discomfort and a sore throat sensation are common in the first days but usually well controlled with scheduled pain medication. Arm pain often improves as the nerve root is decompressed.
For office-based jobs, return is often considered between 2 and 3 weeks if pain is controlled and you feel safe. Physically demanding jobs or those with risk of blows or falls may require 6–8 weeks or longer. Timing is tailored in follow-up based on recovery and job type.
Gentle walking can start early with gradual progression. High-impact, contact sports or activities needing wide, repeated neck motion are usually reintroduced gradually from around 6–8 weeks, following your surgeon’s and physiotherapist’s advice.
The same herniation is unlikely to recur at the fused level. Adjacent discs may degenerate over time, and if the nerve was compressed for long, recovery may be partial. Follow-up helps detect and manage these changes.
Anterior cervical fusion decompresses and stabilises the segment, useful in advanced degeneration or instability. Disc replacement aims to preserve motion with a prosthesis. Simple discectomy without fusion may leave the segment unstable in degenerative disease. The choice depends on age, disc status, number of levels and other factors discussed in consultation.
Not always. It is indicated when significant nerve compression with pain or deficit persists despite conservative care or when stability is needed in degenerated segments. The decision is individualised after weighing risks and benefits with the specialist.

Do these symptoms sound familiar?

If you recognise yourself in some of these symptoms and your pain is starting to limit your daily life, we can review your case in a personalised consultation. Dr. Ben Ghezala will assess your clinical history and imaging studies to help you decide the best treatment option for you.

Request a consultation with Dr. Ben Ghezala