The principal risk from a fusion is that it does not heal. In general, allograft bone does not heal quite as well as autograft bone, but both yield good results when used in the anterior cervical spine.

If a graft is used without instrumentation, there is a small chance (1% to 2%) of a graft dislodgment or extrusion. If this happens, another operation may be necessary to reinsert the bone graft, and instrumentation (plates) can then be used to hold it in place.

The principal disadvantage with using autograft bone is that another incision needs to be made over the hip to harvest the bone graft. Possible complications associated with taking out bone graft include:

• Graft site chronic pain (which happens 10% to 25% of the time)
• Infection
• Hip fracture
• Bleeding
• Damage to the lateral femoral cutaneous nerve (a sensory nerve that supplies sensation to the front of the thigh)

The chances of a complication increase with the size of the bone graft. The bone graft is an important part of the procedure, and many patients find the bone graft harvest site to be more painful than the cervical surgery itself.

If allograft is used, there is a theoretical risk of transmission of an infection from a donor. The risk of contracting HIV from a graft has been estimated to be between 1 in 200,000 to 1 in 1 million.

In skilled hands, this is a very safe procedure. Possible reported risks and complications of anterior cervical fusion may include:

• Non-union
• Damage to the spinal cord (about 1 in 10,000)
• Graft extrusion
• Bleeding
• Continued pain
• Adjacent disc disease
• Injury to the trachea or esophagus
• Difficulty swallowing- usually transient
• Hoarseness of the voice- usually transient
• Injury to the vertebral artery or carotid
• Stroke
• Paralysis
• Infection
• Death