Surgery for neck pain is usually only an option for individuals who have some other symptom in addition to pain, such as a problem with the nerves. The medical term for this condition is cervical radiculopathy, which usually causes pain and often causes abnormal sensations or numbnessin the neck and arms. Some people with cervical radiculopathy may also experience weakness in the arms. Severe cases of cervical radiculopathy may cause symptoms in the lower half of the body, which may interfere with walking, disrupt bowel and bladder function, and cause abnormal sensations/weakness in the legs. When cervical radiculopathy is the cause of the person’s neck pain, surgery may be the answer.
Anterior Cervical Discectomy and Fusion
The most common surgical treatment for neck pain caused by cervical radiculopathy is anterior cervical discectomy and fusion or ACDF. The orthopedic spinal surgeon approaches the spine from the patient’s front (anterior), and removes one or more vertebral discs in the neck (cervical discectomy). The surgeon then fuses the affected vertebral bones together using a bone graft along with plates and screws called hardware. The bone graft helps bridge the gap between vertebral bones and completes the fusion as the area heals.
Posterior laminoforaminotomy (POF) is a cervical treatment for neck pain that is used when the patient is experiencing a cervical radiculopathy caused by a single herniated disc or bone spur in the neck. In POF, the surgeon approaches the spine from the patient’s back (posterior) and removes a bit of the vertebral bone (laminoforaminotomy) to make additional room for the nerves to pass through the foramen (portal through the vertebral bone). POF surgery does not require the use of bone grafts or metal hardware, though many patients experience more pain after POF than after ACDF.1
Surgery for neck pain is and excellent option for individuals who have both neck pain and nerve pain.
Artificial Cervical Disc Replacement
Artificial cervical disc replacement is a relatively new procedure which offers an excellent alternative to fusion. While disc replacements are relatively new, Dr. Rovner has extensive experience successfully performing this procedure.
As with POF, artificial cervical disc replacement may be an option for people who have a problem in a single vertebral disc. In artificial disc replacement surgery (also called cervical arthroplasty), the diseased vertebral disc is removed and replaced with an artificial “joint” or disc. The goal of cervical disc replacement is to mimic the function of the natural cervical disc, which allows rotation, bending, and supports the weight of the head and neck. Artificial cervical disc replacement is a relatively new procedure since artificial discs have only been recently approved by the FDA. Nonetheless, many orthopedic spine surgeons have been using these devices as part of clinical trials and testing programs for many years.
- Storm PB, Chou D, Tamargo RJ. Surgical management of cervical and lumbosacral radiculopathies: indications and outcomes. Phys Med Rehabil Clin N Am. Aug 2002;13(3):735-759.