What to Expect from Cervical Spine Surgery

If spinal pain in your neck has become severe enough to affect your daily life, you may be searching for medical options for relief. If you’ve tried conservative options like physical therapy and anti-inflammatory medications, and they failed to improve your neck pain, it may be time to consider surgery. Cervical spine surgery describes procedures that repair damage to the spine near the neck and shoulders.

Conditions That May Require Surgery

Upper back and neck pain can be caused by several issues, including:

• Herniated discs, which are problems with the soft, jelly-like discs between each vertebra. If these discs tear or squeeze outward, they can put pressure on nerves in the neck, causing pain, numbness and tingling in the extremities, pain in shoulders, arms and hands and even headaches.
• Spinal stenosis occurs when bone growth, bone spurs or calcium deposits cause the space around the spinal cord or nerve roots to narrow, putting pressure on the spinal cord and causing clumsiness or numbness in hands or legs.
• Degenerative disc disease, or the wearing away of the cushioned discs between vertebra, can cause pain and affect range of motion.

There are different types of cervical spine surgery available to repair the damage caused by advanced spine problems.

“Cervical spine surgery isn’t really a one-size-fits-all procedure. We tailor each operation to address the problems for each individual patient,” said Dr. Bryan Wohlfeld, an IU Health neurosurgeon specializing in treating complex and degenerative spine conditions. “Most procedures involve removing obstructions from the sensitive nerves and spinal cord and stabilizing the spine.”

Types of Cervical Spine Surgery

There are different types of cervical spine surgery to alleviate pain and stabilize the spine.

• Anterior cervical discectomy and fusion (ACDF) surgery removes the damaged disc and any bone spurs causing pressure on the spinal cord or nerve roots. Through a horizontal incision in the side or front of the neck, spine surgeons remove the disc and replace it with a bone graft held in place with a titanium plate and screws. As you heal, this graft will eventually fuse with your bone, strengthening this area around the nerves and halting any arthritis. This section of your spine will no longer move, but it shouldn’t affect your overall range of motion.
• Total disc replacement, or arthroplasty (TDA) is a newer procedure that replaces a damaged disc with a prosthetic disc. TDA is an option for select patients with less advanced degeneration. It can preserve mobility and reduce stress on the vertebrae.

When you undergo cervical surgery, it can last between one to six hours, depending on how much repair is needed. You may stay in the hospital or a rehab center following the procedure, or you may return home on the same day of surgery if you have a less degenerative condition.

Your spine may require more than one type of procedure during surgery. For instance, spinal stenosis may need additional steps to alleviate your neck pain.

“With degenerative conditions, we have to consider doing surgery across multiple levels of the spine,” Dr. Wohlfeld said. “Sometimes that means we’ll approach a cervical decompression fusion from the back of the neck, or we’ll remove two discs at once.”

There are risks associated with cervical surgery. These include risk of infection, bleeding, difficulty swallowing or speaking, damage to throat or limited recovery due to preexisting damage to the nerves.

“Sometimes, the symptoms will not fully resolve if there’s preexisting damage to the nerves,” Dr. Wohlfeld said. “This is one reason patients should not delay surgery for too long. If your pain continues to worsen, it can affect your outcome.”

Recovery After ACDF Surgery

Recovery after cervical spine surgery can last between three to six months. During this time, avoid activities that stress the neck, like lifting heavy objects or bending, twisting or tilting your neck. After cervical fusion surgery, your surgeon may recommend that you wear a neck brace, or cervical collar, for several months to avoid stress on the hardware that’s been implanted in your spine.

During recovery, your post-surgical pain will be at its worst during the first three to five days. You may be given medication during that time to reduce pain. You also may notice stiffness after surgery, but this usually improves over time as your muscles recover. The numbness and weakness you’ve experienced on your spine will also improve, though it may take weeks or months.

Ultimately, cervical spine surgery can help alleviate your symptoms and get you back to enjoying life.

“Generally, the success rates for anterior cervical spine fusion surgeries and disc replacements can be high, and most cases the surgery can relieve pain and also improve function in the neck,” Dr. Wohlfeld said.