Neck Surgery

Your doctor may recommend a neck operation for persistent neck pain and to correct physical abnormalities of the cervical spine. Spinal problems in the neck can also cause pain and other symptoms in the head, shoulders, arm or hand. The goals of neck surgery are to relieve symptoms, stabilize the spine, and improve your quality of life.

Common conditions that may require neck surgery include:

• Arthritis of the neck, which is cervical spondylosis

• Bone spurs

• Cervical vertebral fracture

• Degenerative disc disease

• Herniated, bulging or ruptured disc

• Pinched nerve, which is cervical radiculopathy when it occurs in the cervical spine

• Spinal cord compression, or cervical spondylotic myelopathy

• Spinal stenosis, or narrowing of the spinal column

Neck surgery may only be an option for you if other treatments with less risk of complications fail to resolve the problem. This can include medications, spinal cortisone injections, physical therapy, and spinal manipulation.

Orthopedic surgeons who concentrate their practice on the spine commonly perform neck surgery. Orthopedic surgeons specialize in treating diseases, disorders and conditions of the muscles, bones and joints. Other types of doctors may also perform these surgeries, including interventional radiologists, neuroradiologists, and neurosurgeons who specialize in the spine.

Neck surgery often takes place in a hospital, especially if an overnight stay is necessary. However, some neck surgeries are outpatient procedures. Your doctor may perform these surgeries either in a hospital or an outpatient surgery center. The details of your procedure will vary depending on the specific surgery you need. Some require traditional surgical techniques with a large incision. Others lend themselves to minimally invasive approaches with smaller incisions. In general, minimally invasive surgeries result in less pain, fewer complications, and a speedier recovery. Talk with your doctor to find out if you are a candidate for a minimally invasive procedure.

Most neck surgeries are major procedures that require general anesthesia. This allows you to sleep through the entire surgery. In some cases, doctors may recommend regional anesthesia with sedation to make you drowsy and relaxed.

In general, this is what happens the day of your neck surgery: 

• You will meet with a preoperative nurse to help you get ready for surgery. The nurse may perform a brief exam.

• You will talk with an anesthesiologist or nurse anesthetist about your medical history and the anesthesia you will have.

• You will talk with your surgeon to review and discuss final details about the surgery.

• You will receive a sedative to help you relax before the team takes you to the operating room (OR).

• Your team will start anesthesia in the OR. With general anesthesia, you won’t remember anything else until you wake up in the recovery room.

Your surgeon and team take incredible care to prevent complications, but any surgery carries a certain level of risk and the potential for complications Some of these risks and complications can be serious. They can occur during surgery or may develop throughout your recovery.

The general risks of surgery include:

• Anesthesia reaction, such as an allergic reaction and problems with breathing

• Bleeding

• Blood clot, in particular a deep vein thrombosis (DVT) that develops in the leg or pelvis. A DVT can travel to your lungs, which can be life threatening.

• Infection

Most people have successful outcomes after neck surgery. However, potential neck surgery risks and complications include:  

• Nerve, muscle, or blood vessel damage

• Ongoing pain or disability

• Healing problems, which is more common in people who smoke

• Neck stiffness

• Problems with an artificial disc or spinal bone graft

• Pseudoarthrosis after cervical fusion. This condition occurs when there is not enough bone formation to support the graft fusing the vertebrae. It is more common in people who smoke. If it occurs, more surgery may be necessary to correct it.

• Spinal headache, which is due to leaking cerebrospinal fluid

• Worsening or recurrent symptoms

You can reduce your risk of certain complications by:

• Following your doctor’s instructions on activity, dietary and lifestyle restrictions and recommendations before your surgery and during recovery

• Informing your doctor if you are nursing or if there is any possibility of pregnancy

• Notifying your doctor immediately of any concerns, such as bleeding, fever, or increase in pain

• Taking your medications exactly as directed

• Telling all members of your care team if you have allergies

There are steps you can take before surgery that can improve your comfort, health and safety. You can prepare for neck surgery by:

• Arranging a ride home. You will also need someone to stay with you for the first 24 hours.

• Getting preoperative testing if your doctor orders it. This will vary depending on the procedure and your medical history.

• Losing excess weight before surgery

• Making sure all your healthcare providers have your complete medical history. This includes chronic conditions, allergies and medications. When listing medications, include prescriptions, over-the-counter drugs, herbal treatments, and vitamin supplements.

• Not eating or drinking before surgery as directed

• Stopping smoking as soon as possible to help the healing process

• Taking or stopping medications as directed

You can help yourself and your doctor by making a list of questions to ask during your appointments. Questions you may want to ask include:

• Why do I need the neck surgery you are recommending? Are there any other options we can try first?

• How many of these procedures have you performed? Do you have outcomes to share?

• How long with the surgery take? When can I go home?

• What restrictions will I have after surgery? What kind of assistance will I need at home?

• When can I return to work and other activities?

• When will I start physical therapy? How many treatments are typically necessary for recovery?

• How will you manage my pain?

• What changes, if any, to my medication plan do I need to make?

• When should I follow up with you?

• How should I contact you after hours if I have a problem?

Knowing what to expect after neck surgery makes it easier to plan and prepare for a successful recovery.

Neck surgery can take several hours and it is common to stay in the hospital afterwards. The length of your stay will depend on the surgery. In some cases, you may be able to go home the same day. In both cases, your team will give you detailed instructions before you leave. You will have information about medications, incision care, activity level, and follow-up appointments.

Neck surgery recovery may involve wearing either a soft or rigid cervical collar. The collar stabilizes your spine while it heals. It also helps support your head, which takes pressure off your neck during recovery. The length of time you need to wear the collar will vary depending on your surgery.

You will likely start walking and eating the day after surgery. If your incision is on the front of your neck, you may find it easier to swallow soft foods. It can take a few weeks to handle solid foods without difficulty. You may also have hoarseness during this time. Physical therapy usually begins about four weeks after surgery. It will help you regain range of motion and function in your neck. Neck surgery recovery time can range from three months up to a year to return to your full activity level.

You will have some pain and discomfort after neck surgery. Managing your pain is important for a smooth recovery. It allows you to walk and complete rehabilitation activities that are necessary for healing. Tell your doctor if your pain worsens or changes in any way. It could be a sign of a complication.

Contact your doctor’s office during normal business hours if you have questions between follow-up appointments. However, you should call your doctor right away or seek immediate medical care if you have:

• Breathing problems or shortness of breath

• Confusion or changes in level of alertness

• Chest pain, pressure or tightness

• Drainage of pus, redness or swelling around your incision

• Fever. It’s common to have a fever right after surgery, but your doctor will give you instructions about when to call for a fever.

• Inability to urinate or move your bowels

• Leg pain, redness or swelling, which could mean you have a blood clot

• Unexpected bleeding

Outcomes after neck surgery vary depending on the procedure and the person. The goals of surgery also vary. Some aim to improve symptoms and function, while other focus mainly on stabilizing the spine. This means that it is possible to have some level of pain or disability after neck surgery. Talk with your doctor before surgery about the goals of your procedure. Ask about the outcomes of the procedure so you can have realistic expectations for recovery. Find out if you can expect symptom improvement and a return to your activities. For many neck surgeries, these favorable outcomes are possible.