The
goals of cervical spine surgery are to correct instability and relieve
compression from a nerve that may be causing you pain, tingling, burning, or
even weakness from the neck. Often, these symptoms can travel down the shoulder
and into the hands.
The
most common surgeries to relieve neck-related pain are anterior cervical
discectomy with fusion (ACDF) and the newer artificial discreplacement (ADR).
To
answer the big question of whether neck surgery makes sense for you, it helps to think through the
following two questions:
- Do neck pain symptoms greatly reduce my quality of life?
Neck
pain alone can be bad, such as when sharp pain reduces the head’s range of
motion and interferes with daily activities. However, surgery is typically not
considered unless symptoms become even worse with cervical nerve root
compression causing pain, numbness, and/or weakness to radiate into the arm and
hand, or spinal cord compression causing problems with coordination, bladder or
bowel function, or walking.
- Has the surgeon identified a correctible problem that is related to my symptoms?
If
medical imaging, such as an MRI, identifies a spinal problem that is causing
the compression of a nerve root or the spinal cord in a manner that matches
your symptoms, you’re likely a candidate for surgery. For example, if symptoms
appear to be caused by a herniated disc, bone spur (osteophyte), or other
structure pushing against a nerve root or the spinal cord, then in most cases a
surgery can be performed to remove whatever is causing the compression and
allow space for the nerve(s) and/or cord to heal.
The
expectations from ACDF and ADR are to relieve arm/hand-related symptoms first,
followed by neck pain over a couple months as the recovery proceeds.
Weighing the benefits and risks of
neck surgery
For chronic neck pain that cannot be
linked to spinal instability or nerve compression, patients are usually advised
to continue with nonsurgical treatments, such as physical
therapy, medication as needed, massage,
cognitive behavioral therapy, cold packs, heat therapy, and sometimes steroid
injections.
What Condition Is Causing My Neck Pain?
If
your orthopaedic spine surgeon is able to verify that your pain is caused by a
spinal instability and/or compression of a nerve root or the spinal cord, the
chances for successful surgery are dramatically improved. This is especially
true if you have arm and hand symptoms in addition to neck pain.
Both
ACDF and ADR surgeries are relatively safe and have high rates of success, but
they also have risks just like any surgery. Running the potential risk of some
increased neck pain after surgery may be worth it if you’re able to regain full
use of an arm, but it would likely not be worth it if neck pain is your only complaint going into surgery.
At
the end of the day, if your symptoms are debilitating to your activities of
daily living, work, sleep, and interpersonal relationships with family and
friends, it may be time to have a discussion with your orthopaedic spine
surgeon. An accurate diagnosis and treatment plan can have a major role in
achieving a meaningful outcome.
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