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Surgery for neck pain

Introduction

No matter how common neck pain patients are, the neck surgery is a very rare treatment – less than 5% of patients suffering from it really do need a surgical treatment.
There are several common reasons to consider before having a spine surgery:
-     if your non-surgical treatment doesn’t show any effects (exercises, physical terapy and chiropractic, medications…) so you’re still in pain.
-    If your upper body feels numb and you feel tingling and weakness.
-    If it is hard for you to make balance or even walk
-    If you’re general health is otherwise good meaning that you don’t suffer from any musculoskeletal disease or serious stress.
There are certain conditions that are often surgically treated, because these may make an additional pressure on our spinal cord. After the surgery the pressure is relieved and it often relieves the pain and other associated symptoms. These include: spinal instability, degenerative disc diseases or trauma.

Techniques

Typical techniques used in cervical spinal surgery are decompression  and stabilization. First one refers to removing tissue that makes pressure against spinal nerves, while the stabilization concentrates on localizing motion between vertebrae.
Decompression techniques are usually done from the back of our spine. They further divide to :
(1) facetectomy: a technique that removes facet joints (joints in our spine) as a matter of reducing pressure.
(2) foraminotomy: usually conducted in the situations where part of the disc or a bone spur makes pressure on nerve. This technique makes the opening of a foramen larger and thus allowing the nerve to exit without suffering any pressure.
(3) laminectomy: lamina is a bony plate situated at the back of each vertebra. In some cases it may make pressure on our spinal cord so that laminectomy should be conducted to make more room for the cord by lamina removal.
(4) laminoplasty: reshaping of the lamina that creates additional room for our spinal cord.
(5) laminotomy: similar to foraminotomy, it makes an opening in lamina that  pressures our nerve.

In some cases, decompression techniques cannot be conducted from the back of the spine and they must be done from the front. These techniques are also known as anterior decompression techniques and they include:
(1) disectomy: in which the central portion of a disc that presses the nerves is all or partially removed.
(2) corpectomy: method of extraction of an entire vertebra to gain access to the disc that makes pressure on our nerves.
Stabilization techniques are used to restabilize the spine, usually after discectomies and corpectomies that often result in an abnormal movement of the spine:
(1) artificial cervical disc: nowadays used as an implant, instead of fusion and spinal instrumentation, to gain normal movement of the neck.
(2) fusion and spinal instrumentation: involves creating an environment that allows our bones and spine to coalesce together during a long time period (a couple of months or even longer). Resulting fusion will stop movement of the vertebrae resulting in stability.
Possible complications of spinal surgery are common injuries to spinal cord, nerves, carotid artery or vocal cords, infections, pain in bones, swelling in the leg veins, urinary problems, or even blood clots in lungs. Extremely rare but most severe complications are paralysis and death.
If you decide to take surgery you should expect a long-time recovery. You will have to stay in bed and to take pain-killers for 2 to 4 weeks. Your body is going to need a reasonable time to heal and your activities will be limited. That means avoiding sports, heavy lifting, sharp movements etc. If you feel any health problems after the surgery you should instantly consult your doctor.

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