While modern neck surgery procedures are relatively safe, they still carry risks for potentially serious complications, such as infection, allergic reaction, excessive bleeding, or paralysis.
If a surgical solution is considered, all appropriate nonsurgical options must have been exhausted, the patient is considered a good surgical candidate, and the surgeon has reviewed the risks, benefits and alternatives of surgical treatment with the patient as well as answering all questions.
Read more about Cervical Spine Surgery. Cervical Disc Replacement Surgery Video. Back Surgery and Neck Surgery Overview. Postoperative Care for Spinal Fusion Surgery. You are here Conditions Neck Pain. Surgery for Neck Pain share pin it Newsletters. By Scott Curtis, DO. Neck Surgery: The Procedures Surgical procedures to treat neck pain include: Anterior cervical discectomy.
This is the most common surgery to relieve neck pain caused by a nerve-pinching herniated disk. The surgeon exposes your spine through an incision in the front of your neck right next to your windpipe.
Through that incision, the doctor removes the herniated disk and any bone spurs that may be causing pain. Afterward, the space left between the vertebrae is refilled with a piece of bone either your own, taken from your hip bone, or a bone graft from a donor or other material, fusing the adjacent vertebrae together. This procedure is used to relieve pressure on the nerve roots or spinal cord. The laminae are bony plates on the back side of the vertebrae that cover and protect the spinal cord.
Removing the laminae can reduce pressure on the spinal cord and nerves. Doctors also can remove sections of herniated disk and bone spurs through the new opening in the vertebrae. This is used to help people with spinal stenosis by creating more room for the spinal cord within the spinal canal.
After exposing the spine through an incision on the back of the neck, the doctor then reconstructs the vertebral laminae to enlarge the spinal canal. Cervical spinal fusion. This surgical procedure joins together two vertebrae that are grinding against each other because the disk between them has herniated or been worn away. A graft is inserted to fuse together the bones above and below the disc. ACDF surgery may be an option if physical therapy or medications fail to relieve your neck or arm pain caused by pinched nerves.
Patients typically go home the same day. Discectomy literally means "cutting out the disc. The surgeon reaches the damaged disc from the front anterior of the spine through the throat area. By moving aside the neck muscles, trachea, and esophagus, the disc and bony vertebrae are exposed. Surgery from the front of the neck is more accessible than from the back posterior because the disc can be reached without disturbing the spinal cord, spinal nerves, and the strong neck muscles.
Depending on your particular symptoms, one disc single-level or more multi-level may be removed. After the disc is removed, the space between the bony vertebrae is empty. To prevent the vertebrae from collapsing and rubbing together, a spacer bone graft is inserted to fill the open disc space.
The graft serves as a bridge between the two vertebrae to create a spinal fusion. The bone graft and vertebrae are fixed in place with metal plates and screws.
Following surgery the body begins its natural healing process and new bone cells grow around the graft. After 3 to 6 months, the bone graft should join the two vertebrae and form one solid piece of bone. The instrumentation and fusion work together, similar to reinforced concrete. After fusion you may notice some range of motion loss, but this varies according to neck mobility before surgery and the number of levels fused.
If only one level is fused, you may have similar or even better range of motion than before surgery. If more than two levels are fused, you may notice limits in turning your head and looking up and down. Motion-preserving artificial disc replacements have emerged as an alternative to fusion. Similar to knee replacement, the artificial disc is inserted into the damaged joint space and preserves motion, whereas fusion eliminates motion.
Outcomes for artificial disc compared to ACDF are similar, but long-term results of motion preservation and adjacent level disease are not yet proven. Talk with your surgeon about whether ACDF or artificial disc replacement is most appropriate for you. Most herniated discs heal after a few months of nonsurgical treatment. Your doctor may recommend treatment options, but only you can decide whether surgery is right for you.
Be sure to consider all the risks and benefits before making your decision. Your surgeon will also discuss the risks and benefits of different types of bone graft material. Autograft is the gold standard for rapid healing and fusion, but the hip incision can be painful and at times lead to complications.
Allograft bone-bank is more commonly used and has proven to be as effective for routine 1 and 2 level fusions in non-smokers. A neurosurgeon or an orthopedic surgeon can perform spine surgery. Many spine surgeons have specialized training in complex spine surgery. Discuss all medications prescription, over-the-counter, and herbal supplements you are taking with your health care provider. Presurgical tests e. Consult your primary care physician about stopping certain medications and ensure you are cleared for surgery.
Stop taking all non-steroidal anti-inflammatory medicines ibuprofen, Advil, etc. Stop using nicotine and drinking alcohol 1 week before and 2 weeks after surgery to avoid bleeding and healing problems. It kills bacteria and reduces surgical site infections.
Avoid getting CHG in eyes, ears, nose or genital areas. Stop smoking The most important thing you can do to ensure a successful spine surgery is quit using tobacco.
Nicotine prevents bone growth and decreases successful fusion. Smoking also decreases blood circulation, resulting in slower wound healing and an increased risk of infection.
Talk with your doctor about ways to help you quit: nicotine replacements, medications Chantix or Zyban , and counseling programs.
0コメント