Do you have one of the four signs your neck pain needs more than conservative treatment?
If you’ve worked with your doctor about a pinched nerve in your neck, you’ve probably tried a battery of treatments. For many people, medications, physical therapy, and adjustments to daily routines don’t provide relief.
When all other therapy options fail, surgery is usually the next treatment option. But when does a pinched nerve need surgery?
Four Signs You Need Neck Surgery
-
Other treatments have been tried but didn’t help in the long run.
Keeping up with treatments that only give you temporary relief can quickly exhaust your time and resources. Surgery generally isn’t the first line of defense when it comes to nerve pain. But if medication, physical therapy, and lifestyle adjustment barely have an impact on your pain, your doctor may look at surgery.
-
You have degeneration in your spine, which is pinching a nerve.
If parts of your spine are wearing down and causing pressure, conservative treatment probably won’t help. You also run the risk of irreversible or more severe damage if the degeneration isn’t dealt with. Arthritis and aging are the most common causes of this breakdown.1
-
Something is structurally out of place, and it can’t be restored from the outside.
Slipped discs and out-of-place vertebrae can often be fixed with physical therapy exercise or chiropractic care. Most do not cause pain for longer than 6 weeks. But stubborn structures may need surgery to fix it from the inside.
-
Your pinched nerve is causing you serious mobility or sensation problems.
Sometimes, surgery can’t be avoided if the pinched nerve is creating problems down the body.2 Intense disability and pain, and fast-moving problems, are alarm bells that need attention. You should talk to your doctor as soon as possible if you have a pinched neck nerve, then have:
- Worsened bowel and bladder function
- Trouble walking or keeping balanced
- Trouble with fine motor skills, like buttoning a shirt
- Numbness and/or tingling in your legs, arms, or groin area
- Worsening pain
What surgery is done for a pinched nerve in the neck?
The most appropriate surgery for you will be up to your doctor and surgeon. Your surgery will largely depend on which nerve is getting pinched and what is pinching it.
Anterior cervical discectomy and fusion
An anterior cervical discectomy and fusion (ACDF) is one common surgery for pinched nerves in the neck.3 During the surgery, the doctor removes whatever was causing the pressure on your nerves or spinal cord. This could be part of a herniated disc or a bone spur. They enter through the front of your neck, rather than the back, to help preserve the delicate muscles and tendons. This helps you heal faster. They then fuse the vertebrae together. This may reduce neck mobility but can dramatically help stabilize the neck to keep the pressure away.
Artificial disc replacement
An artificial disc replacement can be used if the whole disc itself is creating the pressure. This surgery removes the problematic disc. The surgeon then replaces it with an artificial one in the correct position. Ideally, you may have this option if you don’t have cancer, rheumatoid arthritis, osteoporosis, or instability in your spine.
Foraminotomy
The foramina are gaps in the vertebrae that the spinal cord passes through. Overgrowth of bone can pinch the cord. A foraminotomy opens up this gap so the spinal cord is no longer crowded.4
Laminectomy
A laminectomy is another common surgery for pinched neck nerves. During this procedure, the lamina (a bony ridge on your vertebrae) is removed, along with everything else that’s pinching the nerves. It makes your spinal cord less crowded. A laminectomy can make a vertebra less stable, so people who get this surgery often get a spinal fusion as well.5
Laminoplasty
A similar surgery is a laminoplasty. Instead of removing the lamina, it makes the bone have a hinge-like movement. This enlarges the spinal canal. This is more common with neck pain that is not related to motion, but multiple areas of internal pressure. Surgeries with the lamina typically involve a cut in the back of your neck to access the bone correctly.
Laminoforaminotomy
This is a combination of a laminectomy or laminotomy and a foraminotomy. They’re often performed at the same time. This surgery is used to treat neck pain that radiates down from your shoulders to your arms. It’s a very minimally invasive procedure that only requires a tiny incision.6
What if I’ve already had surgery done? Should I get neck surgery again?
In some situations, another operation is needed. This is after conservative measures are ruled out.
Injury, surgery failure, and general wear and tear can require another surgery. This will be up to your surgeon. If it’s from wear and tear, you may be able to have the same surgery again. If it’s from injury, you may be able to have it surgically restored. If it’s from failure, you may need to have the surgery repeated or a different surgery or therapy performed.
What does the recovery time look like for neck surgery?
It will depend on the surgery. Since you’re dealing with the neck, you’re going to want plenty of time to let it stay stable to recover.
If your surgery is outpatient, like the ACDF mentioned above, you’ll be able to go home and rest within several hours of the surgery. The at-home recovery time is typically a few weeks. For more complex surgeries, like injury-related pinched nerves with complications, your surgeon may want you to stay inpatient for a few days.
Want to talk to a specialist about neck surgery?
If you believe you’re experiencing any of the symptoms of a pinched nerve in the neck, it’s time to talk to your doctor. If surgery is your next step, put your care in the hands of a surgeon you trust. Nerve pain is the Tollestrup team’s area of expertise. If you or your doctor is interested in relieving your pain with surgery, don’t wait. Call our office at 702-666-0463.
References:
- https://pubmed.ncbi.nlm.nih.gov/16103830/
- https://www.spineuniverse.com/conditions/back-pain/when-back-or-neck-pain-emergency
- https://www.healthline.com/health/neck-surgery#:~:text=Anterior%20cervical%20diskectomy%20and%20fusion%2C%20or%20ACDF%20for%20short%2C%20is,the%20front%20of%20your%20neck.
- https://www.columbiaspine.org/treatments/laminectomy-laminotomy-foraminotomy-laminoforaminotomy/
- https://www.healthline.com/health/laminectomy
- https://med.uth.edu/neurosciences/conditions-and-treatments/spine-disorders-and-back-pain/cervical-laminoforaminotomy/
[This article is not medical advice. If you have health concerns, please take them to your physician. This article is not meant to provide a diagnosis or treatment plan.]