Neck Pain

Surgery

Surgery is not necessary for most cases of neck pain, which are typically caused by repeated or prolonged movements to the neck's muscles, ligaments, tendons, bones, or joints.

Surgery may be considered when neck pain is caused by:

• Traumatic injury to the neck that results in a fracture or abnormal motion (instability). Surgery may be done to stabilize the spine and prevent a bone fracture from causing instability and possible paralysis.
• Pressure on the spinal nerve roots or spinal cord that results in pain, numbness, or arm, hand, or leg weakness or that causes severe pain that persists for months despite treatment. However, even neck pain caused by pressure on the nerve roots will usually get better without surgery.⁴
• Narrowing of the spinal canal (cervical spinal stenosis) or arthritis of the neck (cervical spondylosis).

Surgery Choices

Surgeries used to treat neck pain caused by pressure on the nerve roots or by injury or illness include:

• Discectomy (with or without fusion). For more information on discectomy, see the Surgery section of the topic Herniated Disc.
• Cervical spinal fusion, in which selected bones in the neck are joined (fused) together.
• Spinal decompression, in which pressure is reduced on the spinal cord or spinal nerve roots by removing part of a bone or disc.
• Disc replacement with an artificial disc. Some people can consider this surgery instead of spinal fusion. Disc replacement surgery removes a spinal disc that is severely damaged and then replaces it with an artificial disc. This surgery is currently just for carefully selected patients, and it is done by specially trained surgeons. Doctors have not yet done long-term studies to know how well this works over time.

What To Think About

Surgery that is done to relieve neck pain caused by pressure on the nerve roots (especially from a herniated disc) is successful in relieving pain about 80% to 90% of the time.⁵

A minor surgical technique called percutaneous radiofrequency neurotomy has been used for some people with chronic facet joint pain. The facet joint is a portion of the spine in the neck that is sometimes responsible for neck pain after whiplash. One small study suggests that this surgery offers short-term relief for chronic neck pain. Almost 60% of people with whiplash said they were pain-free more than 6 months after treatment.² It is a difficult surgery that requires a highly skilled staff. And the pain will most likely come back over time.

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Author:	Carrie Henley Monica Rhodes	Last Updated: October 16, 2006
Medical Review:	William M. Green, MD - Emergency Medicine Tom Bailey, MD - Family Medicine Robert B. Keller, MD - Orthopedics
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