Neck Surgery: Techniques, Risks, and How to Prepare

Neck surgery is a general term for any surgical procedure used to create more space in the vertebrae of the neck (cervical spine). This reduces compression of the spinal cord and nerve roots. Neck problems can be caused by bulging or herniated discs or spinal stenosis (a condition where the openings in the vertebrae of the neck narrow due to degenerative changes in the spine).

These conditions can cause pinching of the spinal cord itself, or of the spinal nerve roots that exit from the spinal cord. Symptoms of compression in the neck include neck pain, tingling, numbness, weakness, and radiating pain into the arms and hands. When symptoms do not improve after several weeks or months of conservative treatment, surgery might be recommended.

What Is Neck Surgery?

Neck surgery is a scheduled procedure that is usually recommended for severe or progressive forms of nerve or spinal cord compression. Your healthcare provider will likely want you to try conservative measures first, including medications, cortisone injections, and physical therapy.

If your symptoms do not get better and continue to significantly affect your quality of life and make everyday tasks challenging, surgery might be recommended to help decrease the pain, numbness, weakness, and tingling that you are experiencing.

To confirm the diagnosis that's causing your neck pain and other symptoms, your provider will want you to have diagnostic imaging tests. These tests will let them see the anatomy of your cervical spine (in your neck) and help them pinpoint where the issue is located. These tests include:

• X-rays
• Computerized tomography (CT) scans
• Magnetic resonance imaging (MRI)

Various Surgery Techniques

The goal of neck surgery is to relieve the pressure from the spinal cord or nerve roots by creating more space in the openings of the vertebrae of the cervical spine. This can be accomplished by the following procedures:

• Discectomy: A procedure to remove a damaged disc between vertebrae of the spine that may pinch or compress a nerve or spinal cord
• Laminectomy: A procedure to remove a portion of the vertebrae called the lamina (especially if there is a bone spur) to increase space for the spinal cord and nerve roots
• Foraminotomy: A procedure to widen the openings in the vertebrae where the nerve roots exit from the spinal cord (foramina)
• Spinal fusion: A procedure where two or more vertebrae are fused together to stabilize a portion of the spine

A cervical spinal fusion might be needed for conditions such as:

• Spinal fractures
• Severe arthritis
• Multiple bulging or herniated discs
• Spinal stenosis
• Spinal instability

Potential Risks

Neck surgery can help relieve chronic pain that has been unresponsive to other forms of treatment, but it comes with risks. In some cases, symptoms may stay the same or get worse after surgery. Associated risks with neck surgery include:

• Infection
• Bleeding and blood clots
• Nerve damage
• Damage to the membrane that surrounds the spinal cord
• Remaining or returning symptoms
• Need for additional surgery

Talk to your healthcare provider about the possible risks of neck surgery to determine if it is an appropriate option for you given your age, current health status, and medical history.

Purpose of Neck Surgery

Neck surgery is usually performed on adults after conservative measures have not helped with symptoms like pain, numbness, weakness, and tingling that interfere with everyday life. Conservative measures used to treat neck conditions include:

• Medications: Often anti-inflammatories (such as ibuprofen) and analgesics (such as Aspirin)
• Spinal injections: Often given with steroids
• Physical therapy: Used to strengthen the peri-spinal musculature

If no improvement is seen after several weeks of trying these methods and your symptoms continue to significantly impact your daily functioning, your healthcare provider may want to set up a surgical consult for you. This will give you a chance to discuss your options and prepare you for surgery.

How to Prepare

Neck surgery will be scheduled by your healthcare provider. You may have to wait several weeks or even months to schedule your surgery based on the availability of the surgeon and the operating room.

The surgical team will provide you with more detailed instructions on what you will need to do in the days and hours before your surgery. It is recommended that you stay active, eat a healthy diet, and stop smoking before any operation to promote optimal healing and make your recovery as smooth as possible.

You may need to stop taking certain medications in the days leading up to the surgery to prevent excess bleeding or interactions with anesthesia during the operation. Tell your healthcare provider about all prescriptions, over-the-counter (OTC) medications, and supplements that you are taking. They need to know this information to ensure your safety before, during, and after your surgery.

Neck surgery takes place in the hospital. You should expect to stay overnight for one or two days after your surgery. You will not be allowed to drive to or from the hospital before and after your surgery. Make arrangements for a friend or family member to provide transportation for you.

What to Expect

Before Surgery

On the day of your surgery, arrive early to allow for extra time to find your way around the hospital, check in, and fill out all the necessary paperwork. Once all the documentation is completed, you will change into a hospital gown and be given a brief physical examination to clear you for surgery.

You will get an IV put into your arm or hand to give you fluids and medication. Then you will be wheeled into the operating room on a hospital bed. The surgical team will help you get onto the operating table in the operating room. Then, you will be given anesthesia to put you to sleep for the surgery.

During Surgery

Neck surgery can involve you laying on your back or stomach, depending on the procedure. In more complicated cases, the surgery may need to be done on both the front and back of your neck, which will require you to carefully be flipped over on the operating table by your care team during surgery. Depending on the procedure performed, an incision will be made along the front and/or back of your neck.

For discectomies, laminectomies, and foraminotomies, tissue (including disc portions, vertebrae portions, or bone spurs) will be surgically removed to decrease the compression of the nerve roots or spinal cord and create more space.

Cervical spinal fusion surgery might be required if there are fractures and slippage of the vertebrae, significantly herniated discs, or if laminectomies to multiple vertebrae were done (as the cervical spine of the neck will become unstable).

Spinal fusion will help stabilize the affected segments of the neck by removing the disc between the vertebrae and surgically fusing two or more vertebrae together. A bone graft (bone taken from another area in the body) is used to fill in the space where the disc was taken out to help the vertebrae heal and fuse.

Recovery

When your neck surgery is done, you will be taken to a recovery room. You will stay there until you fully wake up from the anesthesia (usually after a few hours). Once you are stable, you will be transported to a hospital room until you are ready to go home (be discharged).

You will be encouraged to get up and walk within 24 hours after the surgery. After you go home, your healthcare provider will schedule a follow-up appointment.

For a discectomy, laminectomy, or foraminotomy, you can expect to stay in the hospital for one to two days before you'll be allowed to go home. Spinal fusion surgeries are more involved and may require a longer stay—three to five days—to make sure you are stable before being sent home.

You may also be given a cervical collar that you will need to wear at all times to protect your neck as it heals. Your surgeon will give you specific instructions, including when you might be able to temporarily take the cervical collar off and when you can stop wearing it.

Long-Term Care

When you have been discharged from the hospital and are settled in at ho,e, you can generally go back to work within a few days to a few weeks after a discectomy, laminectomy, or foraminotomy procedure. You can expect to return to your normal activities about three months into your recovery.

For cervical spinal fusion surgery, it will take several weeks before you can go back to work safely and three to six months for you to fully recover.

A Word From Verywell

Neck surgery is often the last option for treating neck problems. Conservative measures should be tried first.

If you do not experience any improvement, talk to your provider about the risks and benefits of undergoing surgery. They will help decide if it is an appropriate option for you. After surgery, be prepared to take several months to fully recover.