If you pinch a nerve in the neck it can lead to pain down the arm. This is similar to the pain down the leg from a pinched nerve in the lower back which we call sciatica.
Often neck and arm pain will improve over six weeks or so and well directed physical therapy or a targeted neck injection can be very helpful.
If your painful arm symptoms persist then neck surgery can be very successful.
I use this surgery most commonly for a slipped disc in the neck or perhaps removing a bony spur.
For most problems in the neck the best surgical approach is through the front (anterior) of the neck.
I make a small horizontal skin incision and gently dissect to reach the spine without damaging any muscles.
Unlike in the lower back it is normally necessary to remove the whole disc to reach the trapped nerve.
The disc herniation or bony spur is then nibbled away freeing the nerve.
Now we have a choice – fusion or disc replacement?
When performing a fusion I wedge a block of synthetic material (called a cage) into the empty disc space, which avoids taking bone from elsewhere.
The skin is then closed over a drain which is there to collect any blood.
The whole procedure takes just over one hour.
This operation has an excellent chance of being successful regardless of whether I perform a fusion or disc replacement.
You have at least an 80% chance that your arm pain will be better. Neck pain like back
pain may be more unpredictable.
There is a 10-15% that you are improved but not completely better. This may reflect the nerve remaining bruised from being compressed.
Surgery on the neck sounds alarming however it is generally quite safe with a low risk of complications.
There is 2-3% chance of having a complication which includes a nerve injury, spinal fluid leak, infection, implant migration, hoarseness, swallowing problems, bleeding. Spinal cord injury or paralysis is thankfully exceptionally rare.
About 5% of individuals (one in twenty) may have ongoing pain despite the nerve being successfully decompressed.
In my experience patients recover very quickly from anterior cervical surgery and there is no difference in recovery between performing an anterior fusion or disc replacement.
You will wake up with a small drain in the neck which prevents any blood collecting. We remove this simply within 24 hours.
You will be up and about within a few hours of the procedure and home within a day. You will not require a neck collar.
I use a dissolvable suture which patients prefer.
Simple painkillers may be helpful in the first week or so but usually arm pain better very quickly. Pins and needles and numbness may take longer to improve.
Your Swallowing may feel a bit ‘sticky’ due to bruising, but usually settles within a few weeks.
You can build up your walking and aerobic exercise each day.
You can return to work within a few weeks or when you feel ready.
I will see you back in clinic six weeks after your operation and then 3 months later.
You can return to non-contact competitive sport from 3 months, and one year for contact sports such as rugby.
I am here to support you before and after your operation and you can talk to me or the team at any time.
I recommend you read the comments from my patients of their experience under my care.