Neck pain rarely leads to surgery. Surgery may become necessary however, if an injury causes instability or puts pressure on the spinal column or nerve roots. Old injuries and cervical disc degeneration may also become serious enough to warrant surgery. The bones supporting the head and neck are vertebrae connected to the rest of the spine and protect the spinal column. The vertebrae are divided into four categories based on their location. From top to bottom, they are: the cervical spine, thoracic spine, lumbar spine, and sacrum. Like all spinal surgery, neck surgery should not be considered until all other options have been proven ineffective. Doctors will first recommend a retinue of medicine, rest and physical therapy. Surgery is indicated when nerve damage is present or appears to be getting worse. Symptoms of nerve damage are fairly obvious: numbness or tingling in extremities, pain lasting for months, and loss of bowel or bladder function.
Types of Neck Surgeries
The most common procedures are discectomies, vertebral fusions, and spinal decompression surgery.
- During a discectomy, a surgeon will remove all or part of the fibro-cartilaginous disc that separates two vertebrae. This type of surgery is considered when the disc has become herniated (often called a “slipped disc”) and swells, putting pressure on the root nerves or spinal column itself.
- A vertebral fusion, or spinal fusion, is when the movement in a joint is causing or exacerbating nerve damage. A surgeon fuses a bone graft to one of the affected vertebrae and then encourages this bone to grow until the two vertebrae are effectively joined together. This severely restricts movement in the joint but will eliminate pain and prevent further damage.
- Spinal decompression surgeries encompass a number of procedures that all attempt to ease pressure on the spinal column and nerve roots. Damaged parts of the bone or cartilage will usually be removed around the affected area. Surgeons will take out bony growths or spurs that narrow the cavity housing the spinal column. Decompression surgery may also take the form of a total or partial laminectomy— a procedure that removes or alters the laminae, the bony protuberances protecting the back of the spinal column. Decompression may also involve a total or partial discectomy (see above).
Causes and Complications
Conditions leading to surgery can be caused by injury or acquired and congenital conditions. Arthritis can lead to severe pain and inflammation, putting pressure on the spinal column. Surgery may be effective in reducing the swelling, and eliminate potential or current damage. Arthritis, however, is most often treated with anti-inflammatory drugs, physical therapy, and lifestyle changes. Scoliosis or another bone deformity may also make surgery necessary. In general, neck surgery is only considered after non-invasive therapeutic techniques have been exhausted. Your doctor’s advice should be critical in deciding whether or not surgery is the right option for you. While most patients are satisfied with the results of their spinal surgeries, and while complications are rare they do exist. Nerve damage is always a risk when considering surgery around the sensitive nerve roots and spinal column. Infection is a danger that comes along with any surgery. With a spinal fusion surgery, the bone graft may not grow and this will present further complications.
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