When a pinched nerve in the neck is severe and beyond home remedies, then it might require some surgical interventions. In this article we’ll try and explain several surgical intervention methods you may undergo.

Margret a resident of New Jersey developed a pinched nerve in her neck six months ago that was so severe she had to undergo surgery. She had an accident that caused a neck whiplash plus injured several other body parts. She would have tried out other ways of treating the nerve entrapment but couldn’t, as a result the medics opted to go for surgery.

3 Types of Pinched nerve in neck surgery that you could undergo

1. Anterior cervical discectomy and fusion

Anterior cervical discectomy and fusion is the most common and carried out surgical procedure for pinched nerve in the neck. Its aim or rather workability is that it restores the alignment of your spine, maintains the space available between your discs for your nerves to leave your spine and limits motion of and around the degenerated spine segment.

When a pinched nerve occurs in your neck, this is an indication that an underlying problem is affecting your neck. This is because the pinching can be caused by a bulging disc, herniated disc or a slipped disc.

In all the three situations, the nerve will be affected at the nerve root. Pressure will be exerted on the nerve root and this will pinch your nerve at that point.

This however is very dangerous. Remember, the nerves that pass though your spine serve the rest of your body. Additionally your vertebral column is cushioned with a disc which in between one disc and the other is a considerable space.

It is through this space that nerves branch to serve the other parts of your body. At the branching section is which we call nerve root. Any change in shape of the discs in the neck region and in this case the cervical disc will entrap the nerve at the nerve root.

When this happens, the rest of the body which was to be served by the nerve will be affected. That explains why a pinched nerve at your neck will affect to as felt as your fingers and hand.

Bulging, herniation and slipping of any of your cervical disc may be the cause of pinching. This surgical method is anterior. This means that your doctor will start the surgery from the front side of your neck.

surgery for pinched nerve in neck
Correcting a pinched nerve in neck using surgery.

It involves an operation from the front of the neck though a 1-2 inch incision along the neck crease. The disc which is bringing about all the problems is removed. Then the left over area is stretched so that the height is similar to what it was prior to the disc wearing our.

Then a bone graft will be placed in the space where your disc was removed. This is to increase the space in the foramen for your nerve to leave the spinal cord. After placing the bone graft, the two vertebrae next to the disc which was removed are fused together.

This fusion will eliminate motion between your degenerated vertebrae. This is a measure to decrease that pain that is consuming you. It will limit painful motion between the vertebrae.

A metal plate and screws will be used along the front of your cervical spine. They will provide you stability and will help increase the rate of fusion. It is likely to take a bit long but you will need to speed it.

As we have already seen, a bone graft will be used to fill that part that is left open after your damaged disc is removed. The main aim of this is to stimulate bone healing and help the vertebrae to come together as a solid bone.

A graft can be obtained from your body. Yes, I mean your body. This is what is called an auto graft. This will mean that your surgeon will harvest the bone graft from your hip. This in return will increase your surgical time. Auto grafts have been used for sometimes and they are known to work well but with some people it will take them pain for some times into healing period.

Alternatively, your surgeon may not harvest the bone graft from your body. They can do an allograft, this is a cadaver bone. It is acquired through a bone bank. The main advantage why an allograft has grown and many patients would opt for it and might be you will also opt for the same is that it avoids the risk of pain in the donor’s site.

So before an anterior cervical discectomy and fusion is carried on you, your doctor will discuss the pros and cons of autograft and allograft to enable you to be better placed to make a choice.

2. Posterior cervical laminoforaminotomy

The word posterior in this procedure means that it is carried out from the back of your neck. The cause of pinching of your nerve must be one that has occurred from the back.

It involves, a 1-2 inch incision, which is made along the midline of your neck. Though the incision, then the part of the bone that is compressing your nerve is removed.

Some causes of pinched nerve may not actually require surgery. Sometimes your pinched nerve may be due to a poor posture which could have caused the neck bones to dislocate. This kind of dislocation will mean that the nerves that are next to this bone will be tampered with. This will require a complete reversal of structure by returning the dislocated bones to their normal position.

A bulging disc will create some additional space with the protrusion which it causes. Due to this your nerve root will be affected though compression or constriction. When posterior cervical laminoforaminotomy is carried out on your neck then the bulging disc will be removed completely.

A herniated disc will lead to some kind of bulging of your particular disc. In addition, the disc will have some cracks which are extra dangerous as they can hurt your nerves. This is because they can cut the nerve into two parts.

This will mean that your nerve will be nonfunctional completely. With this type of surgical procedure, you will need to remove the herniated disc.

With a slipped disc, the bulging is an obvious thing but in addition pieces of the slipped disc will be evident. They are the materials which add stress on your neck nerves. This procedure will not only remove the slipped disc but also the pieces which are a product of the rapture exercise which occurred on your disc.

This surgical procedure avoids spinal fusion and in its place will allow potentiality for recovery. Remember this is only necessary if the cause of your pinching of the nerves can be addressed from the back.

3. Artificial disk Replacement

This is a surgical procedure which is an improvising mechanism. The cause of pinching will be removed and it its place will be put another material which can act the one removed.

An artificial disk replacement is a procedure which is carried out from the front. Your doctor will make a 1-2 inch incision at the front side of your neck. This will be along your neck crease. After making the incision then they will remove the problematic disc.

The disc will be degenerated. It is likely to have slipped, bulged or compressed. Remember the pinching of a neck nerve can come out in two cases. First is when the nerve which lies in the hollow space in your spine is pinched. Mostly this effect is to the sciatic nerve. This is the second largest nerve in your body. Its pinching therefore will mean wide felt implications.

This can be due to the three reasons we already say above, bulging, slipping or herniation. To all the three reasons, the nerve may be affected if the effect of the disc is to the inside space of your spine.

In this case the bulging will have created a protrusion to the lumen of your spine. This means that it has eaten up on the space which houses some of your very crucial nerves.

Secondly, the pinching of your neck nerve can be on the nerve root. This is where the nerves that serve your auxiliary body parts are affected. Remember between the discs that are placed one on the other in a professional arrangement to form part of your spine are some spaces. This spaces are the ones through which nerves leave your spine.

When any change in structure happens on your disc, then the nerves in these discs are affected. They lead to pinching of your nerve at the nerve root.

When this problematic disc is removed another material which is shaped just similarly to the disc removed is placed there. The implant can be made of metal or metal and plastic. It is effectively designed to maintain the motion between the vertebral bodies.

Artificial disks will allow motion to continue after the degenerated disc is removed. This disc may restore the height between your vertebral bodies. It may also widen the passageways through which the nerve roots exit the spinal canal.

english annotated diagram of ACDF surgery
english annotated diagram of ACDF surgery (Photo credit: Wikipedia)

This artificial disc will relieve pressure on the facet joints and help to maintain the natural curvature of the cervical spine. At one point in life you have had to use an improvised device to accomplish what you intended.

A good example is when a car develops a problem. You are very much in the interior or you are in the remote areas. It could also be that you do not have finances. Then instead of hiring a breakdown you tell a friend to come and help you out.

When helping you out, your friend will use a rope, tie it to both cars and in this case pull your car to where you want. On the centrally a breakdown would have tied a metal rope or actually carried your car.

This mechanism is what applies with artificial disk replacement. This procedure is very efficient as the side effects are minimal. There is always a lower risk of problem levers below and above the artificial disc.

Artificial disc replacement may not be an option for some patients, this will depend on the type and the location of your problem or rather the problematic disc.

Risks of pinched nerve in neck surgery

There exist various risks associated with the three injuries. However, this should not hinder you from obtaining a treatment. The risks are few compared with the associated benefits.

It is likely that during any of the injury you may develop severe bleeding. This is a common case with people suffering from hypertension or diabetes. Remember in this case we are dealing with the neck, this bleeding may reach your brain cells and this would be dangerous.

As the doctor makes an incision on your neck, if care is not employed it is likely that you would hurt some nerves. Remember the condition that might have brought about the degeneration of your disc. As the disc is being removed it is likely to hurt your nerve. Some discs may have cracks or may have ruptured and this can be dangerous considering that your nerves are very delicate.

This can be coupled with a dural tear. This is the tearing of the sac that covers your nerves.

Another big risk is that to the spinal cord. Your spinal cord’s alignment may be tampered with if the degenerated disc is removed and nothing is put in that place. Before healing takes place, your spine will be weak.

Other risks include a need for additional surgery in future and your body’s reaction to anesthesia.

Pinched Nerve in Neck After Surgery Rehabilitation

Recovery and rehabilitation of your neck will be different in different people. This is dependant on your body’s reception of the surgery and the type of the surgery that was carried out.

Immediately after the surgery you will need to be hospitalized for two or three days. However, start eating and walking immediately.  You may also need to wear a collar, whether soft or rigid, for 4 to 6 weeks.

Immediately after the neck collar, you will need to perform a gradual range of exercises to restore your motion. These are neck exercises. During the period you had a neck collar; your neck was immobile and will therefore lose function. Hence the need of exercises. They are gradual so that you do not harm your neck.

With time you will get used and finally you will be able to perform high motion exercises. Most people will be able to return to full activity in three to four months. However it may take long to some people and more so if you needed spinal fusion. It may take some people up to twelve months.

With time you will return to normal functionality. Be patient with the healing as it is a gradual process.