Surgical Treatment Options for
Cervical Pain
Seldom does neck pain require surgical
intervention, as conservative management is successful 75 to 80%
of the time. Indications for surgery include, but are not limited
to:
¨
Unbearable pain,
unrelieved by conservative management
¨
Progressive weakness in
an arm or hand that may result in paralysis or permanent
impairment of function.
¨
Spinal cord
compression. Symptoms may include weakness in the legs, making
ambulation difficult.
Surgical decompression of a nerve or
spinal cord is effective in 80% of patients. Procedures may
include one of the following:
¨
Microsurgical
Foramentomy for a cervical disc rupture and some types of
spondylosis (a condition of the spine marked by stiffness of a
vertebral joint). The procedure emphasizes minimal disruption of
normal structures.
¨
Cervical
Laminectomy where a portion of the bony
lamina (thin, flat plate or layer of bone) is removed to provide
more room for the nerve and spinal cord that is compressed.
¨
Posterior
Cervical Fusion for trauma where a
fracture dislocation ha occurred. It is also used for
degenerative arthritis in which subluxation (instability) is
present.
¨
Anterior Cervical
Fusion remains the surgery of choice for relieving pressure on
the spinal cord and nerve from a ruptured disc or bony spur (osteophyte).
The term is derived from the words anterior, which means
front, cervical, which means neck, and fusion, which
means joining the vertebrae with a bone graft.
When a disc ruptures in the
cervical spine, it often puts pressure on a nerve(s) or on the
spinal cord, causing symptoms (see above). In this operation, it
is important to remove the pressure, allowing the nerve to heal.
A small incision is made in the front of the neck, usually on the
right side. The muscles of the spine are spread, and the disc is
removed. Any bony spurs, or osteophytes, that are causing
compression of the nerve(s) and spinal cord are also removed at
this time. The disc space is then replaced with a small plug of
bone taken from a bone bank (cadaver bone) or from your hip. In
time, the bone will fuse, or join the two vertebrae it lies
between. This may take 2-3 months.
The layers of the incision are closed with sutures that dissolve.
Small steri-strips (butterfly tapes) are applied to the skin.
A rigid neck brace is worn for 6-8 weeks to restrict movement and
allow the fusion to heal.
For more information or to view the cervical brace, click on the following web site address: http://www.nsg-online.com/Braces/braces.asp
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