Dr. Dan Albright, orthopedic surgeon from Raleigh, NC, discusses when to consider surgery for neck pain.
When do you need surgery for neck problems?
Cervical spine surgery is usually done for herniated discs. A herniated disc is the shock absorber between the vertebrae which is a bit like a jelly doughnut. When the jelly doughnut is compressed, jelly squirts out. When this happens as a herniated disc, there is often pressure on a nerve.
Typically with a herniated disc you’ll get shoulder blade pain, shoulder pain, and pain shooting down the arm. That can be awful, truly awful. You can’t sleep. You can’t work.
First, we’ll try therapy and medicines. We try rest. We try steroid injections. You try to give it a month, but nothing’s working. This is usually when surgery is recommended.
There are two ways to do cervical spine surgery. Sometimes the surgeon can go in from the back and do a simpler operation in some patients, but most commonly patients require anterior cervical surgery which is from the front. The surgeon goes in and removes the whole disc. By removing the disc, the disc rupture herniation is off the nerve. This relieves the pain. Then the space left from the removed disc has to be filled with something. And for decades the world has done ACDFs. ACDFs are Anterior Cervical Spine Fusions and decompressions. It’s a terrific operation.
Recently surgeons started doing Cervical Disc Replacements which I think may be even a better operation. The beauty here is you get the pressure off of the nerve and put in a replacement disc and you can move. Nature likes motion.
The cervical disc replacements have outstanding research support behind the procedure. It’s the same approach, almost the same operation as a fusion you just happen to not fuse it. You don’t take away motion to keep the motion in there.
If you have arm pain and nothing’s worked – this surgery is outstanding. The science is really strong to support that. To cure nerve pain, arm pain, shoulder blade pain and help neck pain.
Most times for neck pain we do not do surgery – that’s an important point. Most neck pain can be helped with exercise, good mechanics, proper ergonomics, some anti-inflammatories and therapy – swimming that type of thing. But surgery for nerve pain and a herniated disc is a real success story. It’s a simpler operation than the lumbar spine. The cervical spine is much easier to treat in many ways.
If you have more questions or any questions, contact Dr. Dan Albright at 919-863-6808.