Cervical Spine Surgery: A Comprehensive Guide for Complex Cases

Cervical spine surgery is a specialized field that addresses degenerative, traumatic, and congenital disorders of the cervical region. While many clinics provide general information on the topic, few offer a deeply integrated, expert-led, and patient-centered perspective. In this guide, we combine the latest evidence, clinical experience, and unique insights from Dr. Vicenç Gilete, one of the world’s leading neurosurgeons in treating complex cervical instability in patients with connective tissue disorders.

What Is Cervical Spine Surgery?

Cervical spine surgery refers to a range of procedures that aim to relieve compression on the spinal cord and nerves, stabilize the cervical vertebrae, and restore alignment and function. It is commonly recommended for conditions such as:

• Herniated cervical discs
• Cervical spinal stenosis
• Cervical spondylosis
• Cervical myelopathy
• Degenerative disc disease
• Traumatic injuries
• Atlantoaxial Instability (AAI)
• Craniocervical Instability (CCI)

In our clinic, many patients also present with underlying connective tissue disorders such as Ehlers-Danlos Syndrome (EDS), which adds a layer of complexity to diagnosis and treatment.

Symptoms That May Indicate Cervical Instability

Patients with cervical issues often report:

• Chronic neck pain
• Headaches
• Dizziness and vertigo
• Visual disturbances
• Difficulty swallowing
• Arm weakness, pain and/or numbness
• Unsteady gait
• Urinary symptoms

These symptoms can stem from conditions like CCI or AAI. It is important also to rule out a subaxial (below C2) instability. As Dr. Gilete explains, “We use MRI & uCBCT and AI-enhanced prone MRI to diagnose cases of cervical instability”. This technology allows for unparalleled precision in imaging and correlating symptoms with structural pathology.

How Is Cervical Spine Surgery Diagnosed and Planned?

Diagnosis starts with a detailed clinical evaluation followed by advanced imaging:

• Supine MRI
• Cone-beam CT (uCBCT)
• Flexion-extension and rotational views

We also assess inflammatory, immunological, and genetic markers when connective tissue disease is suspected. According to Dr. Gilete, “Most of our patients are international and travel to Barcelona for a combined imaging and consultation visit with our team.”

This multidisciplinary and personalized assessment ensures that we only recommend surgery when non-invasive options have been exhausted.

Types of Cervical Spine Surgery We Perform

Anterior Cervical Discectomy and Fusion (ACDF)

Removes herniated or degenerated discs and stabilizes the spine by intervertebral cages between vertebrae. Usually this is the most appropriate surgical option in cases of EDS or hypermobility spectrum disorder.

Cervical Disc Replacement

An alternative to ACDF that maintains motion by replacing the damaged disc with an artificial implant. In cases of EDS or hypermobility spectrum disorder, though it is an option to be considered, it will depend on some other patient circumstances.

Occipitocervical Fusion

Indicated in advanced CCI and AAI cases. As Dr. Gilete notes, “Surgical intervention is a last resort but where warranted, can significantly improve quality of life for advanced cases.”

Atlantoaxial Fusion

Stabilizes the C1-C2 segment in patients with rotational instability. Often used in EDS patients with ligament laxity.

Multilevel Fusions and Deformity Corrections

For patients with widespread instability or severe kyphosis and lordosis imbalance, especially in syndromic cases.

Surgical Process and Safety Protocols

Surgeries are performed at Teknon Medical Center, one of the few European hospitals accredited by the Joint Commission International (JCI).

“Once in the Operating Room, surgery is performed under general anaesthesia, with onsite Neurophysiological monitoring (SSEP), neuronavigational guidance and intraoperative CT scan guidance,” explains Dr. Gilete.

These tools reduce the risk of injury and ensure optimal cage or/and screw placement. “We ensure that the spinal cord, cranial and cervical nerves are protected, reducing the risks when placing the screws for the fusion.”

Postoperative Care and Recovery (ACDF example)

• ICU stay: 1 day
• Neurosurgical ward: 3-4 days
• Begin sitting and walking within 24 hours
• Weekly follow-ups in Barcelona for 1 week post-discharge

Our team provides comprehensive rehabilitation planning, with international patients advised to remain in Barcelona for optimal monitoring.

A Unique Approach to Cervical Surgery for EDS and Complex Cases

What makes our approach different is the integration of biomechanical, immunological, and neurofunctional diagnostics. We are the only clinic in Europe recognized by the Ehlers-Danlos Society as a Center of Excellence.

“Dr Gilete is one of only a very few neurosurgeons in the world experienced in diagnosing Craniocervical Instability (CCI) and Atlantoaxial Instability (AAI) in a neglected and often misunderstood population of patients.”

This specialized experience ensures accurate diagnosis and a tailored approach for each patient.

FAQs About Cervical Spine Surgery

Is cervical spine surgery safe?

Yes, when performed by experienced surgeons with appropriate technology, cervical spine surgery has a high success rate and low complication profile.

How long is the recovery time?

Patients typically return to light activity within 2–4 weeks. Full recovery may take 1–2 months depending on the complexity of the procedure.

Will I lose neck mobility after surgery?

Some procedures reduce mobility in specific segments (e.g., C0-C2 in fusions), but overall function is preserved. Disc replacement can preserve more motion. As an example, every single subaxial levels account for around a12% neck mobility (approx.).

Is this surgery suitable for EDS patients?

Yes. In fact, our center specializes in such cases.

Can I be diagnosed remotely?

Yes. We offer telemedicine consultations and remote imaging review services.

Conclusion

Cervical spine surgery can restore function and alleviate suffering in patients with debilitating cervical conditions. However, for those with complex disorders like EDS, CCI, or AAI, only a handful of centers in the world offer the expertise and personalized care required. Dr. Gilete’s team at Promohealth SL stands at the forefront of this field, integrating advanced diagnostics, surgical excellence, and compassionate care. We invite patients from around the world to submit their imaging or schedule an in-person consultation in Barcelona. Begin your path to stability and recovery with the only EDS-recognized spine surgery team in Europe.