What is Neck Surgery?
Neck surgery is a surgical procedure employed for the treatment of neck pain when conservative measures such as physical rehabilitation, medications, and rest have failed to provide any relief to your neck pain.
The neck supports and assists in movement of the head. It is the most flexible part of the spine and consists of 7 cervical vertebrae, cervical segment of the spinal cord, spinal nerves, ligaments, tendons and muscles. Neck pain can be secondary to a problem affecting any of these structures.
Usually neck pain occurs due to damage to the soft tissue such as muscles, ligaments, and nerves, which may occur either due to an injury or wear and tear associated with the aging process. Neck pain can also result from infections, tumors, or congenital abnormalities of the vertebrae.
Indications for Neck Surgery
Neck surgery is generally indicated for one of these reasons:
- To mitigate pain caused by nerve root impingement as a result of bone spurs or material from a herniated or ruptured disc, a condition known as cervical radiculopathy
- To prevent vertebrae from rubbing against each other due to degenerative disk disease, which generates neck pain from pinched nerves
- To eliminate pressure on the spinal cord caused by bone spurs, a condition known as spinal stenosis (narrowing of the spinal canal)
Preparation for Neck Surgery
You will have a preoperative assessment session before surgery. During your assessment, you must inform your doctor about any health conditions you may have such as diabetes or bleeding disorders, and about any medications that you may be taking, such as blood thinners, over-the-counter medications, or supplements. You may be asked to stop taking certain medicines for several days before the procedure. Complete nicotine cessation prior to any surgery is strongly advised as nicotine interferes with skin, muscle and bone healing.
Your doctor will explain the surgical procedure, its risks and benefits, and answer all your surgery-related queries before the procedure. Blood tests, X-rays or other imaging tests may also be ordered to assess your medical condition.
Procedures for Neck Surgery
When pain and symptoms fail to improve with non-surgical treatment measures such as activity modification, pain medication, non-steroidal anti-inflammatory drugs, muscle relaxants, physical therapy, or spinal injections, neck surgery procedures are employed for the treatment of neck pain, and may include:
- Cervical laminectomy: This procedure is undertaken to alleviate pressure on the spinal cord or the nerve roots. The spinal cord is covered and protected by laminae, which are bony plates on the backside of the vertebrae. Pressure on the spinal cord and nerves are reduced by removing the laminae. Also, during this procedure, sections of bone spurs and herniated disk can be removed through the opening in the vertebrae.
- Cervical laminoplasty: This procedure is used to assist people with spinal stenosis by making more space for the spinal cord within the spinal canal. During this procedure, the spine is exposed by making an incision on the back of the neck and the vertebral laminae are reconstructed to enlarge the spinal canal creating more room.
- Anterior cervical discectomy: This is regarded as the most common surgical procedure performed to mitigate neck pain caused by a nerve-pinching herniated disk. During this procedure, the spine is exposed by making an incision in the front of the neck right next to the windpipe. Through that incision, bone spurs or herniated discs that may be causing pain are removed. Then, a piece of bone (either your own or a bone graft from a donor) or other material is used to refill the space left between the vertebrae, fusing the adjacent vertebrae together.
- Cervical spinal fusion: During this procedure, two vertebrae that are rubbing against each other are fused together as the disk between them has worn out or herniated. A metal implant or bone graft is used to fuse the vertebrae, which ultimately grows together into one bone.
- Posterior microdiscectomy: This approach is employed to treat a large soft disk herniation located on the side of the spinal cord and is performed by making a vertical incision in the posterior of your neck. A high-speed burr is utilized to detach some of the facet joints to identify the nerve root under it. The nerve root is gently moved aside to make room for the surgeon to remove the disk herniation.
Postoperative Care and Instructions
Post surgery, you may have to stay in the hospital for at least a week. You will have to wear a neck brace or protective equipment to aid in healing and to support the neck. Complete recovery may take about 5 weeks or more. You will be instructed on avoiding heavy lifting or exertion for several months. You will be given an exercise regimen to strengthen your neck muscles and improve neck function. You will also be instructed on activity modifications, diet, wound and dressing care, bathing, driving, pain medications, etc, for a complete recovery.
Risks and Complications of Neck Surgery
As with any surgical procedure, neck surgery involves potential risks and complications that include:
- Damage to the spinal cord or nerves
- Infection of the area around the spine or bone graft
- Failure in fusing together of 2 vertebrae
- Damage to veins and arteries that pass through the neck into the brain
- Bone graft displacement before occurrence of the fusion