What causes neck pain?
What is a herniated disc?
What is the difference between a herniated disc and a bulging disc?
Are bulging or herniated discs normal?
Does whiplash cause herniated discs?
Should I have a MRI if I have pain?
What can I do to avoid surgery?
Are there alternative therapies available to help me deal with my pain?
When do I need surgery?
Will I have irreversible damage if I delay surgery?
When do I need a fusion?
Why is surgery often done through the front of the neck?
Is a plate necessary? Will I set off metal detectors?
What effect does a fusion have on the rest of the cervical spine?
Should I have allograft or autograft bone?
Will the surgery lessen my mobility?
Will I have pain after surgery?
What are my chances for success?
What are my risks?
Will I have to wear a collar after surgery?
When will I be back to my normal activities? Driving?
What causes neck pain?
The most common cause of neck pain is muscle strain or sprain. Less common causes are disc herniations, infection, fractures, disc degeneration, arthritis, and tumors. Most neck pain is self limited, improving with rest, and anti-inflammatory medications. If your neck pain persists for longer than 1-2 weeks, you should seek your doctor’s advice.
What is a herniated disc?
The disc is made up of two components. The center of the disc is composed of a soft substance called the nucleus. The outer band of the disc is a fibrous ring called the annulus. A disc herniation is when the outer band has torn, allowing the soft center to escape.
What is the difference between a herniated disc and a bulging disc?
The disc is made up of two components. The center of the disc is composed of a soft substance called the nucleus. The outer band of the disc is a fibrous ring called the annulus. A disc bulge is when the outer ring is protruding. A disc herniation is when the outer band has torn, allowing the soft center to escape.
Are bulging or herniated discs normal?
Bulging and even herniated discs, while they are not normal, can be a very common occurrence in the spine.
Does whiplash cause herniated discs?
The motions involved in a whiplash injury result in injury to surrounding musclulature and ligaments. Due to the unavoidable degeneration of discs, the herniation of a disc during a whiplash injury may be due to aggravation of an already bulging disc. It is not common practice to do screening MRI’s to evaluate an individual’s neck and thus without prior imaging noting completely normal discs, one can not completely blame whiplash for a herniated disc.
Should I have a MRI if I have pain?
The evaluation of pain is usually a multi-step process and a MRI is not always the first choice. Depending on the description of the pain and the setting in which the pain initially occurred will drive the physician’s decision-making process and the appropriate work-up and treatment.
What can I do to avoid surgery?
In most cases, conservative measures including physical therapy, pain medication, anti-inflammatory medication, and rest can provide significant relief without surgery. There are situations in which the cause of symptoms or clinical picture may warrant surgical intervention to prevent any irreparable nerve damage or further injury.
Are there alternative therapies available to help me deal with my pain?
There are alternative therapies available to treat pain including physical therapy, pain medication, anti-inflammatory medication, cervical traction, aquatic therapy, as well as epidural steroid injections or alternative medicine such as acupuncture.
When do I need surgery?
Surgical intervention is usually reserved for patients who have failed to improve with conservative measures (physical therapy, pain management, epidural steroid injections). There are situations where surgery is the first option, such as a traumatic event, in order to prevent any irreparable harm to neural structures.
Will I have irreversible damage if I delay surgery?
In most cases, a period of conservative treatment including physical therapy, pain medication if necessary, and rest can improve one’s symptoms. There are situations where the compression on a nerve root or the spinal cord in general, if left
alone, can cause irreversible damage and thus prompt attention to relieve the pressure is paramount.
When do I need a fusion?
Cervical fusion is generally indicated in cases where there is instability in the spine. In addition, when a herniated disc is symptomatic and is removed from the front a fusion is beneficial for neck stability, maintaining cervical height and alignment.
Why is surgery often done through the front of the neck?
The majority of problems that initiate from problems in the neck are located in the front. Access to the problem area is more accessible through the front of the neck. The musculature can be separated instead of cut which promotes better and faster healing.
Is a plate necessary? Will I set off metal detectors?
A plate is utilized during a cervical fusion in order to provide stability while the bony fusion is taking place. The material used in generating the plate does not set off metal detectors.
What effect does a fusion have on the rest of the cervical spine?
Cervical fusion results in greater stress on the adjacent levels of the spine. The spine is exposed to stressors constantly and the discs allow for absorption of that stress. With a fusion and the loss of a disc, the levels above and below that area are now exposed to greater levels of stress. This can result in increased progression of degenerative disease.
Should I have allograft or autograft bone?
There are advantages to both. Allograft bone is a great substitute to your own bone and especially with the bone stimulating factors that are now available to increase the bone fusion, allograft bone is an excellent choice. The advantage of an autograft is that it is genetically like you and already contains excellent bone growth factors. However, these advantages are generally not enough to outweigh the pain and further risk of infection and bleeding with autograft bone.
Will the surgery lessen my mobility?
Generally a one level cervical fusion does not greatly reduce your mobility. Of course, this depends on the level of the fusion and your mobility prior to the surgery. Multi-level cervical fusion will decrease your mobility somewhat, but with physical therapy, good range of motion can usually be maintained.
Will I have pain after surgery?
There is usually some initial postoperative pain, but this tends to diminish within the 1st week or 2.
What are my chances for success?
Generally the success rate for cervical fusion and pain relief are quite high. The type of surgery, the number of levels, and any complications play a key factor in this particular question, but overall, the chances of pain relief are quite good.
What are my risks?
The risks associated with an anterior cervical fusion include bleeding, infection, damage to any surrounding structures including the vasculature, the esophagus, the trachea, the spinal cord and the vocal cords as well as failure of instrumentation or fusion with further need for surgery, weakness, paralysis, coma, and even death. The percentage of these risks is low, but they are all potential risks.
Will I have to wear a collar after surgery?
Wearing a cervical collar after a one level anterior cervical fusion depends on surgeon preference. With a multi-level fusion, a cervical collar is generally indicated.
When will I be back to my normal activities? Driving?
Recovery time varies depending on the type of surgery and the number of levels fused. In general it can last anywhere from 2-4 weeks to 3 months or more depending on the type of activities that you participate in or that your occupation requires. Driving can generally be resumed in 2-4 weeks depending on the type of surgery and the need for a cervical collar. Driving while wearing a cervical collar is generally avoided due to restricted movement required for proper visualization of surrounding vehicles.
