If you’re considering surgery for neck pain, one of your concerns might be whether the procedure could actually make symptoms worse. Cervical spine surgery, or surgery around the neck, often has high success rates. No surgery, however, is free of some risk.
As with any surgery, one of the keys to success is to first ensure that you’re a good candidate for the procedure. If your surgeon is able to accurately diagnose the problem, then your chances for success are favorable and the risk of persistent neck pain can be reduced.
Does surgery for neck pain make sense for you?
The goals of cervical spine surgery are to correct instability and relieve compression from a nerve that may be causing you pain, tingling, burning, or even weakness from the neck. Often, these symptoms can travel down the shoulder and into the hands.
The most common surgeries to relieve neck-related pain are anterior cervical discectomy with fusion (ACDF) and the newer artificial disc replacement (ADR).
To answer the big question of whether neck surgery makes sense for you, it helps to think through the following two questions:
- Do neck pain symptoms greatly reduce my quality of life? Neck pain alone can be bad, such as when sharp pain reduces the head’s range of motion and interferes with daily activities. However, surgery is typically not considered unless symptoms become even worse with cervical nerve root compression causing pain, numbness, and/or weakness to radiate into the arm and hand, or spinal cord compression causing problems with coordination, bladder or bowel function, or walking.
- Has the surgeon identified a correctible problem that is related to my symptoms? If medical imaging, such as an MRI, identifies a spinal problem that is causing the compression of a nerve root or the spinal cord in a manner that matches your symptoms, you’re likely a candidate for surgery. For example, if symptoms appear to be caused by a herniated disc, bone spur (osteophyte), or other structure pushing against a nerve root or the spinal cord, then in most cases a surgery can be performed to remove whatever is causing the compression and allow space for the nerve(s) and/or cord to heal.
The expectations from ACDF and ADR are to relieve arm/hand-related symptoms first, followed by neck pain over a couple months as the recovery proceeds.
Weighing the benefits and risks of neck surgery
For chronic neck pain that cannot be linked to spinal instability or nerve compression, patients are usually advised to continue with nonsurgical treatments, such as physical therapy, medication as needed, massage, cognitive behavioral therapy, cold packs, heat therapy, and sometimes steroid injections.
If your orthopaedic spine surgeon is able to verify that your pain is caused by a spinal instability and/or compression of a nerve root or the spinal cord, the chances for successful surgery are dramatically improved. This is especially true if you have arm and hand symptoms in addition to neck pain.
Both ACDF and ADR surgeries are relatively safe and have high rates of success, but they also have risks just like any surgery. Running the potential risk of some increased neck pain after surgery may be worth it if you’re able to regain full use of an arm, but it would likely not be worth it if neck pain is your only complaint going into surgery.
At the end of the day, if your symptoms are debilitating to your activities of daily living, work, sleep, and interpersonal relationships with family and friends, it may be time to have a discussion with your orthopaedic spine surgeon. An accurate diagnosis and treatment plan can have a major role in achieving a meaningful outcome.