There are many neck conditions that may require surgical intervention to get treated. Neck surgery is the last resort when the other conservative treatment becomes unsuccessful in reducing the discomfort in the neck from a particular condition.
The common conditions which may require neck surgery are as follows:
- A pinched nerve (cervical radiculopathy): In this condition, excess pressure is placed on one of the nerve roots of the neck.
- Spinal cord compression (cervical myelopathy): This condition occurs due to the compression and irritation of the spinal cord.
- Broken neck or neck fracture: A break in one or more bones of the neck leads to neck fracture.
7 Common Types Of Neck Surgeries
There are different types of neck surgeries. The one needed for you depends on the neck condition you are suffering from.
Cervical Spinal Fusion
- This surgery involves the joining of two of the vertebrae into a single stable piece of bone. It is used in the case when an area of the neck is unstable and there is pain during the motion of the neck.
- Cervical spinal fusion is used in the case of severe fractures of neck, pinched nerve and spinal cord compression.
- Depending on the condition, an incision is made at the back of the neck. A bone graft is placed into the affected area. The two vertebrae are kept together with the help of metal graft and plates.
- There may be a decrease in motion and flexibility due to fusion.
Anterior Cervical Diskectomy And Fusion (ACDF)
- ACDF is a type of neck surgery done to treat pinched nerve or spinal cord compression.
- During the procedure, an incision is made in the front of the neck. The disc suppressing the spinal cord is removed. This helps relieve the pressure on the nerve or spinal cord.
- Spinal fusion is done thereafter to provide stability to the area.
Anterior Cervical Corpectomy Fusion (ACCF)
- This type of neck surgery is similar to ACDF and is a good option when bone spurs are the cause and cannot be removed by ACDF.
- Like in ACDF procedure, an incision is made in the front of the neck and a disk is removed, in ACCF all part of the front of the vertebra and any surrounding bone spurs are removed.
- The space left is filled using a small piece of bone and spinal fusion. This procedure involves a longer recovery time than ACDF.
- Laminectomy is done to relieve pressure on the spinal cord and nerves.
- The incision during the neck surgery is made at the back of the neck. After the incision, the bony, rigid area at the back of the neck known as lamina is removed. If there are any bone spurs, disks or ligament causing compression, they are also removed.
- This allows more space for the spinal cord. This procedure makes the spine less stable. In some who go for laminectomy spinal fusion is also performed.
- Laminoplasty is an alternative procedure for laminectomy. It also relieves pressure from the spinal cord and associated nerves.
- In this type, instead of removing the lamina, a door like a hinge is created. The door is used to open the lamina and reduce compression on the spinal cord. To keep the hinges in place metal implants are inserted.
- The advantage of this procedure is that it preserves some range of motion and the surgeon is able to address multiple areas of compression.
Artificial Disk Replacement (ADR)
Artificial disk replacement is done to treat a pinched nerve in the neck.
It involves an incision at the front of the neck. After an incision is made the surgeon removes the disc that is applying pressure on the nerve. An artificial implant is placed in the empty area where the disk was located.
This surgery, unlike ACDF, helps retain the range of motion and flexibility to some extent.
Artificial disk replacement is not recommended if the following factors are present.(1)
- Existing instability of the spine
- Allergy to the implant material;
- Ankylosing spondylosis
- Neck arthritis
- Rheumatoid arthritis
Posterior Cervical Laminoforaminotomy
- This surgery is another option for pinched nerve treatment and is minimally invasive.
- The incision is done at the back of the neck. With a special tool part of the lamina, any additional bone or tissue, pressing the nerve is removed.
- This surgery does not require spinal fusion and also retains more flexibility of the neck.
The Recovery Period Of Neck Surgery
- Depending on the type of surgery performed, the time of hospital stay can be estimated.
- Mostly the neck surgeries involve one night stay in the hospital. The patient is discharged after a day or two.
- There are pain and slight discomfort which can be relieved with the prescribed painkillers. Most people can walk and eat the day after surgery.
- Some exercises and light activities are advised by the doctor but lifting heavyweight, driving, and work is not recommended.
- The cervical collar is advised to stabilize and protect the neck. Physical therapy is also advised to restore the strength and range of motion.
- The recovery time depends on the type of surgery involved to treat the condition.
Risks Involved With Neck Surgery
As with any type of surgery, there are certain risks involved with neck surgery as well, and that includes:
- Bleeding at the incision site
- Infection at the incision site
- Injury to the nerve and spinal cord
- Leakage of cerebrospinal fluid
- Pain and stiffness after surgery
- C5 palsy
- Incomplete spinal fusion
- Loosening or dislodging of the screws and plates
In such a case additional surgery would be required.