Surgery for Neck Pain

If your doctor determines that pain is due to a disc herniation that is compressing the nerve as it leaves the spine, he or she may recommend a procedure called a cervical foraminotomy.

Disc herniation can result in the narrowing of the foramen, an opening in the vertebra through which nerves travel outward from the spinal cord. In this surgery, doctors remove some or all of the bone spurs or herniated disc fragments that may be crowding the foramen space and putting pressure on the nerve root.

At NYU Langone, this procedure can be performed using a minimally invasive technique that enables surgeons to access the cervical spine through a small tubular device with the aid of a microscope. First, the tube is inserted through a small incision in the back. After the tube is placed near the affected vertebra, surgeons use live X-ray images to guide small surgical tools through the tube and remove any material putting pressure on the nerves.

Doctors then remove the tube and close the incision with stitches. The procedure takes about an hour, and most people return home the same day.

If spinal instability in the neck is causing pain, surgeons may elect to perform a cervical spinal fusion. In this procedure, surgeons permanently join unstable vertebrae using screws and a small piece of bone material called a bone graft. The bone graft may be taken from your own body, typically the hip, or from a donor through a bone bank. Over time, the joined vertebrae fuse.

This procedure provides the cervical spine with the stability it needs to support the head and maintain flexibility. It also eliminates pain caused by a slipped vertebra, which pushes against nerve roots or the spinal cord.

The cervical spinal fusion can be performed from the front or the back of the neck. The front of neck procedure is less painful, and people typically go home the day after surgery. If multiple levels of the spine have to be treated, a back of neck operation is selected and the hospital stay is about two to three days.

During spinal fusion surgery, doctors may also widen the foramen space, trim the facet joints, remove some or all of a herniated disc, or remove bone spurs. These actions create more space in the spinal canal and take pressure off the nerve roots or spinal cord, eliminating the source of pain.

There are several techniques surgeons may use to perform a cervical spinal fusion. Factors including a person’s age, how much of the spine is affected, and whether he or she has had previous spine surgery affect the type of surgery doctors decide is most appropriate.

Typically, a cervical spinal fusion requires a one- or two-night stay in the hospital so doctors can monitor the bones as they begin to fuse and heal.

After surgery, you spend several hours in the recovery room. NYU Langone pain management specialists are available 24 hours a day to ensure you’re comfortable during the initial stages of recovery. Our surgeons perform spinal fusions using techniques designed to cause as little postoperative pain as possible, but spine surgery can be painful.

A physical therapist also visits you after surgery to help you get used to moving your neck around the newly fused bones. He or she also shows you simple exercises to rebuild strength in the muscles in and around your neck and help you stand and walk.

Some people need to wear a neck brace after surgery to stabilize the cervical spine while it heals. Your surgeon makes this decision with you. Typically, you need a brace if doctors performed a spinal fusion to correct multiple vertebrae. If your doctor recommends a neck brace, an orthotics specialist can custom-fit one for you.

When you’re discharged from the hospital, pain management doctors give you medication that is taken by mouth in the weeks following surgery. How long you need the medication and how quickly your neck heals depend on many factors, including your age, the type of procedure done, and if you had nerve damage before the surgery.

Doctors schedule a follow-up appointment 10 days after surgery, then every 6 to 8 weeks until your bones have healed. During these appointments, doctors may use imaging tests, such as X-rays and CT scans, to monitor your healing. For most people, a full recovery takes fewer than four months.