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Posterior Cervical Decompression and Fusion (PCDF)

A surgical approach to relieve spinal cord and nerve compression in the neck

A photo of Dr Colum Nolan, Senior Consultant Neurosurgeon of Oxford Spine & Neurosurgery Centre

Dr Colum Nolan
Senior Consultant Spine & Neurosurgeon
MB, BCh, BAO, LRCPSI, MRCSI, FRCSI (Neurosurgery)

Posterior Cervical Decompression and Fusion, commonly referred to as PCDF, is a cervical spine surgery performed from the back of the neck. It is used to relieve pressure on the spinal cord or nerve roots while stabilising the cervical spine when instability or multi-level compression is present.

PCDF may be considered when symptoms persist despite non-surgical treatment, or when imaging shows significant compression affecting the spinal cord or multiple cervical levels.

Understanding Cervical Spinal Cord and Nerve Compression

Conditions affecting the cervical spine can lead to pressure on the spinal cord or nerve roots. This may result in symptoms such as:
  • Neck pain or stiffness
  • Pain radiating to the shoulders or arms
  • Numbness or tingling in the hands
  • Weakness in the arms or legs
  • Changes in balance or coordination
When compression is extensive or involves multiple levels, a posterior surgical approach may be recommended.

What Conditions May Require Pcdf

PCDF may be recommended for individuals with:
  • Cervical spinal stenosis affecting multiple levels
  • Cervical myelopathy with spinal cord compression
  • Cervical spine instability
  • Degenerative changes involving the posterior elements of the spine
  • Persistent or recurrent symptoms after previous cervical surgery
Not all cervical spine conditions require surgery, and treatment recommendations are based on clinical findings and imaging correlation.

How Is PCDF Performed?

PCDF is performed under general anaesthesia through an incision at the back of the neck.
During the procedure:
  • Bone and soft tissue causing compression are removed to decompress the spinal cord and nerve roots.
  • Stabilisation is achieved using surgical implants and bone grafts to support fusion of the affected vertebrae.
The goal is to relieve pressure on neurological structures while restoring stability to the cervical spine.

PCDF Compared with Anterior Cervical Surgery

Cervical spine surgery can be performed from either the front or the back of the neck, depending on the location and extent of compression.
  • Anterior Cervical Discectomy and Fusion (ACDF) is performed from the front of the neck and is commonly used for disc-related compression affecting one or two levels.
  • Posterior Cervical Decompression and Fusion (PCDF) is performed from the back of the neck and may be preferred when compression involves multiple levels, the spinal cord is compressed from behind, or when additional stabilisation is required.
The choice between anterior and posterior approaches is based on anatomy, alignment, and clinical presentation rather than preference for a specific technique.

Recovery After PCDF

Recovery following PCDF varies depending on the number of levels treated and individual patient factors.
In general:
  • Hospital stay is required for post-operative monitoring
  • A cervical brace may be recommended during early recovery
  • Gradual return to daily activities is encouraged
  • Fusion develops over several months
Follow-up appointments are important to monitor healing and neurological recovery.

How PCDF Fits Into the Overall Care Pathway

PCDF is usually considered after careful assessment and discussion of non-surgical options, including:
  • Medication and activity modification
  • Physiotherapy or rehabilitation
  • Pain management procedures
Surgery is discussed when these measures are insufficient or when neurological compromise or instability is present.

Care at Oxford Spine and Neurosurgery Centre

Cervical spine surgery at Oxford Spine and Neurosurgery Centre is guided by detailed clinical assessment and imaging review. Both anterior and posterior approaches are considered to ensure treatment is appropriate for each individual.

Care is led by Dr Colum Nolan, a senior consultant neurosurgeon with more than 20 years of clinical experience, with emphasis on patient understanding, appropriate surgical selection, and structured follow-up.

In Summary

Posterior Cervical Decompression and Fusion is a surgical option used to relieve spinal cord or nerve compression in the cervical spine while restoring stability. It is often considered for multi-level disease, spinal cord involvement, or complex cervical pathology, and forms part of a comprehensive approach to cervical spine care.

Medical Disclaimer
This page is intended for general educational purposes only and does not constitute medical advice. Information provided is not a substitute for professional medical consultation, diagnosis, or treatment. Suitability for cervical spine surgery must be determined by a qualified medical practitioner following appropriate clinical assessment.

Our Spine & Neurosurgeon in Singapore
Dr Colum Nolan
MB, BCh, BAO, LRCPSI, MRCSI, FRCSI (Neurosurgery)

Dr Colum Nolan is a Senior Consultant Neurosurgeon with over 20 years of experience, specialising in minimally invasive spine (keyhole) surgery and other spine procedures. 

A graduate of the Royal College of Surgeons in Ireland, Dr Nolan underwent neurosurgical training in Ireland and Australia, followed by a fellowship in complex spine surgery at Addenbrooke’s Hospital, Cambridge, as well as rotations at the Orthopaedic Spine Unit in Norfolk and Norwich Hospital. 

Dr Colum is committed to delivering compassionate, patient-centred care, combining surgical precision with a genuine dedication to improving his patients’ quality of life.

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