What is Special about Neck Surgery?

Sep 15, 2014 @ 06:31 PM — by Aron D Rovner, MD 
Treating patients with cervical spine or neck pain is one of the most satisfying surgeries that I do. The reason is many. A patient presents with a herniated disc or degenerative disc in their neck. By the time I see them, they have been through non-surgical management. This may include months of physical therapy, acupuncture, chiropractic care, and epidural injections. Some of these treatment options can be successful. I am a proponent of epidural injections on selected patients. However, they tend not to last more than a few months. When I see these patients, they have been in constant pain for months or years, and they see no way out. Patients typically present with neck pain, headaches, arm pain, numbness, and weakness. Doctors call this radiculopathy and referred pain. The diagnosis is typically a herniated disc, degenerative disc disease, or another disorder of the cervical spine.

Surgery:
The way I approach this is with a minimally invasive surgery called anterior cervical discectomy and fusion. The patient is brought into the operating room and lies on his or her back. A small incision (typically 3 cm) is made on the side of the neck. It is usually made within the creases, so after healing, it is cosmetic, and usually not very noticeable. The disc is removed with minimal muscle sparing. This allows me to remove any irritation on the spinal nerves. A bonegraft is placed in the space followed by a cervical plate. This is a small titanium plate has a very low profile. The incision is then closed. There is usually very little blood loss through the surgery. Most patients wake up and notice an immediate relief of their arm pain. It is very dramatic. They leave the hospital the next day, but sometimes they feel well enough to go home the same day.

Results:
Why I like this surgery so much is because, it is minimally invasive, so minimal blood loss. It usually results in a cosmetic scar that is minimally visible. And most important it has a very high success rate. The vast majority of patients are happy.

A Recent Experience:
I recently had a patient in my office that was a candidate for a cervical fusion. She was very apprehensive, even after I answered all of her questions. She returned to my office three times. I patiently answered each of her questions, but she really feared surgery. In the waiting room were two of my patients that had anterior cervical discectomy surgery. One was two weeks prior, and the other was three months prior. Both patients were extremely happy with the results of their surgery. Since all three were patients, they trusted each other. In the short time of being in the waiting area, they convinced her to undergo the surgery. She just had her neck surgery last week, and she has since called me twice telling me how she wished she decided on the surgery. She is now pain free. It is because of stories like that, that I consider cervical surgery my favorite surgery.