Neck pain is a common condition that can have many different causes. Although surgery is a potential treatment for long-term neck pain, it’s rarely the first option. In fact, many cases of neck pain will eventually go away with the right type of conservative treatments.
Conservative treatments are nonsurgical interventions aimed at reducing neck pain and improving function. Some examples of these treatments include:
- over-the-counter or prescription medications to ease pain and inflammation
- home exercises and physical therapy to help strengthen your neck, increase your range of motion, and relieve pain
- ice and heat therapy
- steroid injections to reduce neck pain and swelling
- short-term immobilization, such as with a soft neck collar, to help provide support and relieve pressure
Neck surgery is often a last resort option if conservative treatments aren’t effective at reducing chronic neck pain.
Continue reading as we take a closer look at the conditions that may require neck surgery, some common types of neck surgery, and what recovery may involve.
Not all causes of neck pain require surgery. However, there are some conditions where surgery may ultimately be the best option, especially if less invasive treatments weren’t effective.
Conditions that may require surgery are often the result of an injury or age-related degenerative changes, like osteoarthritis.
Injuries and degenerative changes can cause herniated disks and bone spurs to form in your neck. This can place pressure on your nerves or spinal cord, leading to symptoms like pain, numbness, or weakness.
Some of the most common neck conditions that may require surgery include the following:
- A pinched nerve (cervical radiculopathy): With this condition, excess pressure is placed on one of the nerve roots in your neck.
- Spinal cord compression (cervical myelopathy): With this condition, the spinal cord becomes compressed or irritated. Some common causes include osteoarthritis, scoliosis, or an injury to the neck.
- Broken neck (cervical fracture): This happens when one or more of the bones in your neck is broken.
There are several different types of neck surgery. The type of surgery you may need depends on several factors, including what’s causing your condition, your doctor’s recommendation, and your personal preference.
Here are some of the most common types of neck surgeries.
Cervical spinal fusion
Cervical spinal fusion joins two of your vertebrae into a single, stable piece of bone. It’s used in situations where an area of the neck is unstable, or when motion at the affected area causes pain.
A cervical spinal fusion may be performed for very severe cervical fractures. It may also be recommended as part of a surgical treatment for a pinched nerve or compressed spinal cord.
Depending on your specific condition, your surgeon may make the incision at the front or back of your neck. A bone graft is then placed into the affected area. Bone grafts can come from you or from a donor. If a bone graft comes from you, it’s typically taken from your hip bone.
Metal screws or plates are also added to hold the two vertebrae together. Eventually, these vertebrae will grow together, providing stabilization. You may notice a decrease in flexibility or range of motion due to the fusion.
Anterior cervical diskectomy and fusion (ACDF)
Anterior cervical diskectomy and fusion, or ACDF for short, is a type of surgery that’s done to treat a pinched nerve or spinal cord compression.
The surgeon will make the surgical incision at the front of your neck. After making the incision, the disk that’s causing the pressure and any surrounding bone spurs will be removed. Doing this may help relieve the pressure on the nerve or spinal cord.
A spinal fusion is then performed to give stability to the area.
Anterior cervical corpectomy and fusion (ACCF)
This procedure is similar to ACDF and is done to treat compression of the spinal cord. It may be the best surgical option if you have bone spurs that can’t be removed by a surgery like ACDF.
As in ACDF, the surgeon makes the incision at the front of your neck. However, instead of removing a disk, all or part of the front area of the vertebra (the vertebral body) and any surrounding bone spurs are removed.
The space that’s left is then filled using a small piece of bone and spinal fusion. Because this procedure is more involved, it may have a longer recovery time than ACDF.
The purpose of a laminectomy is to relieve pressure on your spinal cord or nerves. In this procedure, the surgeon makes the incision at the back of your neck.
Once the incision is made, the bony, ridged area at the back of the vertebra (known as the lamina) is removed. Any disks, bone spurs, or ligaments that are causing compression are also removed.
By removing the back part of the affected vertebra, a laminectomy allows more space for the spinal cord. However, the procedure can also make the spine less stable. Many people who have a laminectomy will also have a spinal fusion.
A laminoplasty is an alternative to laminectomy to relieve pressure on the spinal cord and associated nerves. It also involves an incision on the back of your neck.
Instead of removing the lamina, the surgeon creates a door-like hinge instead. They can then use this hinge to open up the lamina, reducing compression on the spinal cord. Metal implants are inserted to help keep this hinge in place.
The advantage of a laminoplasty is that it preserves some range of motion and also allows the surgeon to address multiple areas of compression.
However, if your neck pain is related to motion, a laminoplasty may not be recommended.
Artificial disk replacement (ADR)
This kind of surgery can treat a pinched nerve in your neck. The surgeon will make the incision at the front of your neck.
During ADR, the surgeon will remove the disk that’s applying pressure to the nerve. They’ll then insert an artificial implant into the space where the disk was previously located. The implant may be all metal or a combination of metal and plastic.
Unlike ACDF, having an ADR surgery allows you to retain some of the flexibility and range of motion of your neck. However, ADR
- existing instability of the spine
- allergies to the implant material
- severe neck arthritis
- ankylosing spondylosis
- rheumatoid arthritis
Posterior cervical laminoforaminotomy
This type of surgery is another option for treating a pinched nerve. The incision is made in the back of the neck.
After the incision is made, the surgeon uses a special tool to work away part of your lamina. Once this is done, they remove any additional bone or tissue that’s pressing on the affected nerve.
Unlike other neck surgeries like ACDF and ACCF, posterior cervical laminoforaminotomy doesn’t require spinal fusion. This allows you to retain more flexibility in your neck.
This surgery can also be performed using minimally invasive methods.
Generally speaking, you can expect to spend a day or two in the hospital following your surgery. Exactly how long you’ll need to stay in the hospital will depend on the type of surgery you’ve had.
Often, neck surgeries require only night, whereas lower back surgeries typically require longer stays.
It’s normal to feel pain or discomfort while recovering. Your doctor will likely prescribe medication to help relieve your pain.
Most people can typically walk and eat the day after their surgery.
Some light activities or exercises may be recommended following your surgery. However, you may not be allowed to work, drive, or lift objects once you return home from your surgery. Your doctor will tell you when you can resume your normal day-to-day activities
You may need to wear a cervical collar to help stabilize and protect your neck. Your doctor will give you specific instructions on how and when you should wear it.
A few weeks after your surgery, you’ll likely begin to do physical therapy. This is very important to help restore strength and range of motion to your neck.
A physical therapist will work closely with you during this time. They’ll also recommend exercises for you to do at home between your physical therapy appointments.
Depending on the surgery, your total recovery time can vary. For example, it can take between 6 and 12 months for a spinal fusion to become solid.
Sticking closely to your recovery plan can greatly help toward a positive outcome following your neck surgery.
As with any procedure, there are risks associated with neck surgery. Your doctor will discuss the potential risks of the procedure with you prior to surgery. Some risks related to neck surgery can include:
- bleeding or hematoma at the surgical site
- infection of the surgical site
- injury to the nerves or spinal cord
- leakage of cerebral spinal fluid (CSF)
- C5 palsy, which causes paralysis in the arms
- degeneration of areas adjacent to the surgical site
- chronic pain or stiffness following surgery
- a spinal fusion that doesn’t completely fuse
- screws or plates that become loose or dislodged over time
Additionally, the procedure may not work to relieve your pain or other symptoms, or you may need to have additional neck surgeries in the future.
There are also specific risks associated with whether the surgery is performed at the front of your neck (anterior) or the back of your neck (posterior). Some known risks include:
- Anterior surgery: hoarseness, trouble breathing or swallowing, and damage to the esophagus or arteries
- Posterior surgery: damage to arteries and stretching of nerves
Neck surgery isn’t the first option for treating neck pain. It’s typically only recommended when less invasive treatments aren’t effective.
There are some types of neck conditions that are more often associated with neck surgery. These include issues like pinched nerves, compression of the spinal cord, and severe neck fractures.
There are several different types of neck surgery, each with a specific purpose. If surgery is recommended for the treatment of your neck condition, be sure to discuss all your options with your doctor.