When Is Neck Surgery Necessary? Diagnosis & Treatment Options
How is Neck Pain Diagnosed?
An accurate and thorough diagnosis is key to selecting the best treatment options. The following is part of a comprehensive diagnostic workup:
- Medical History – Assessment of symptoms, previous treatments and care.
- Physical Examination – A careful examination by a spine specialist for limitations of movement, problems with balance and pain. The examination should also cover loss of reflexes in your extremities, muscle weakness, loss of sensation or signs of spinal cord damage.
- Diagnostic Tests – Generally, X-ray films are taken which allows the physician to see any abnormalities in your spine and rule out other problems such as infections, tumors or fractures. CT Scans and MRIs are often used to give them a three dimensional view of the lumbar spine, soft tissue and can help detect degenerative problems and potential herniated discs.
What are the Treatment Options for Neck Pain?
Non-Operative Treatment for Neck Pain
Conservative treatments are usually suggested for up to 2 months.
- Medications: Non-steroidal anti-inflammatory drugs (NSAIDS) muscle relaxers and on rare occasions narcotic medications
- Heat/Cold Therapy: Alternating heat and cold compresses
- Physical Therapy: Exercises are prescribed to include stretching, massage, and strengthening
- Spinal Steroid Injections: These injections are used two-fold. First to relieve inflammation of the affect soft tissue of spinal cord and secondly, diagnostically to confirm the correct affected level at which the pain originates from.
Least Invasive Pain Management Procedures for Treatment Of Neck Pain
There are a number of pain management treatment procedures that can help reduce painful symptoms in the neck, shoulder, arms and hands.
- Cervical Epidural Steroid Injection
- Cervical Facet Radiofrequency Ablation
- Triggerpoint Injection
Minimally Invasive Spine Surgical Options For Neck Pain
Artificial Disc Replacement – Damaged disc and any bone spurs pressing on the spinal cord or nerves are decompressed and removed. Once the disc is prepared, a durable plastic and metal device that moves in a similar fashion to the natural disc in inserted into the disc space. The specific advantages of the artificial disc replacement is to maintain the motion, maximize function, and minimize the long-term risks to the disks above and below this level.
Anterior Cervical Discectomy and Fusion – Two or more vertebrae are immobilized with surgical plates and screws. Bone graft is placed in the space between the vertebrae to encourage growth of the bones together. Sometimes it is possible that the fusion does not eliminate the patient’s pain for whatever reason and additional surgery may be required.
Posterior Laminectomy – Some or all of the lamina, or posterior part of the vertebra is removed on both sides, along with the spinous process and spinal ligament that binds the vertebrae together. Sometimes a spinal fusion is incorporated with a laminectomy due to spinal instability.
Posterior Foraminotomy – The foramen or openings on the sides of the vertebra, through which spinal nerves exit the spinal column, is removed to reduce pressure on the nerve. Often a spinal fusion is incorporated due to spinal instability after decompressing of the foramen.
How Long Does Neck Surgery Recovery Take?
Most patients can begin getting out of bed one hour after surgery and go home shortly afterward. With a spine fusion the time for post-operative recovery is much longer and may involve overnight stay in the hospital. During neck surgery recovery, activity is gradually increased and patients are typically able to return to work within a few days. There will probably be some pain after the procedure and is usually localized to the incision site. However, just because there is less or no pain, always consult your physician before beginning any physical work.
At home, you will need to continue to rest as you recover from neck surgery. You will be instructed on how to gradually increase your activity. You may still need to take the pain medications for a while. However, pain and discomfort should begin to reduce within a couple of days after surgery. The doctor will discuss with you other techniques for reducing pain and increasing flexibility before you leave for home. The doctor will also discuss with you a time frame for when you can resume basic activities such as walking, driving and light lifting, and when you can return to more advanced activities such as physical labor, sports and yard work.