Neck pain is a common ailment, and it might be plaguing you as you start to feel the effects of working from ad hoc home office or slumped over your dining room table. The vast majority of the time, neck pain can be alleviated with improved posture, NSAIDs, ice and heat treatments, massage and physical therapy. But not always.
If you’ve tried at-home treatments and you’re still experiencing pain, I recommend you contact your family doctor and schedule an MRI. An MRI can tell your physician if you have any bulging discs, arthritis of the spine or other non-muscular issues that warrant further evaluation and treatment. If so, your doctor should refer you to a neurosurgeon for additional evaluation.
Loss of sensation or function and weakness in the arms are other red flags. If you have either of these symptoms, you should be referred to a neurosurgeon right away.
Surgical Options for Neck Pain
About 80 percent of neck pain can be treated conservatively. But if conservative treatments fail, surgery may be necessary. After evaluating the patient and reviewing imaging, there are three procedures I typically consider:
- Anterior cervical discectomy and fusion (ACDF) is the most common procedure used for treating neck pain. It involves removing the problem disc and then placing a bone graft to fuse the above and below vertebrae supplemented with titanium plate and screws. ACDF is actually the gold standard of treating cervical disc disease. We typically use ACDF when patients have radiculopathy, or pain radiating down the arm.
- Spinal decompression surgery (also called laminectomy) removes the back part of the spine (called the lamina) to relieve pressure on the spinal cord. Another type of decompression surgery is facetectomy, which removes the small joint between the vertebrae to reduce pressure on a nerve.
- Cervical disc replacement is a newer procedure that’s been around a little over 10 years. It involves removing the diseased disc and replacing it with an artificial disc. In the correct patient, cervical disc replacement works well. But you need to have the problem be the disc itself. If you have a disc herniation that is putting pressure on a nerve, then disc replacement surgery is a very good option. However, if you have arthritis of the spine, then a disc replacement isn’t going to correct the problem.
Recovering from Neck Surgery
If you’re considering cervical spine surgery to treat your neck pain, you’re probably wondering what recovery looks like. Whether you are a candidate for discectomy and spinal fusion or disc replacement surgery, the recovery process is similar.
Most patients will spend only one night in the hospital. Post-operative restrictions for all procedures are the same. They include: no heavy lifting and avoiding twisting or bending the neck for six to eight weeks. You will be prescribed pain medication and will not be able to drive, and in some cases, return to work while taking it.
Pain relief and the ability to return to normal activity varies greatly among patients, and depends on your health before surgery and the extent of your spine problems. As with any surgery, the key to recovering as quick as possible is following your post-operative care instructions and completing physical therapy as directed.
Learn more about the causes and treatment for neck pain here.