Spine Cervical

Surgeon's Toolbox: New Hardware for Neck Surgery

If you have a degenerative neck condition, your doctor may recommend surgery. In most cases, the surgeon removes a damaged intervertebral disc and replaces it with a chunk of bone. Think of the results as a bone sandwich, with the new bone--or graft--as the filling. The hope is that the graft will attach to the other bones, fusing solidly.

The Leg Bone's Connected to the--Neck Bone? The Success of a Surgical Technique

If you have neck pain from a herniated or degenerating disc, your doctor may eventually recommend surgery. Surgeons usually get to the problem disc by operating through the front of the neck. They take out the damaged part of the disc and replace it with bone from elsewhere in the patient's body or from another source. The goal of this type of surgery is for the bones to grow back together, forming one solid bone.

I am having surgery to take pressure off of the spinal cord in my neck. My doctor says the results of my MRI can be used to predict how I will do after surgery. Is this really possible?

As you may know, MRI stands for magnetic resonance imaging, a test that allows doctors to see pictures of tissues in the body. Certain patterns seen on MRI are thought to give an indication of how well a person will do after surgery to take pressure off the spinal cord. When the pattern shows lots of tissue damage in the spinal cord, the results of surgery may not be as good.

I had surgery through the front of my neck to fuse bones in my spine, and now I have to have the same procedure again. Am I more at risk for complications the second time around?

Possibly. One of the risks associated with this kind of surgery is damage to the recurrent laryngeal nerve, or RLN.

The RLN runs to the voice box (larynx) from both sides of the neck. RLN injuries can result in hoarseness or even loss of voice from vocal cord paralysis. 

My 70-year-old mother is having surgery to take pressure off the spinal cord in her neck. Does her age put her at a disadvantage?

Possibly. A recent study showed that, compared to people in their forties and fifties, older patients were less likely to have good results from this kind of surgery. However, other factors also come into play.

What's the best way to predict whether patients will get good results from neck surgery to relieve pressure on the spinal cord?

Their age and the length of time they've have had symptoms of spinal cord pressure seem to be good clues as to how well patients will do after this kind of surgery. In a recent study, patients who were in their forties or fifties and had symptoms for about a year did better than older patients whose symptoms had lasted two or three years.

I've heard that surgery to fuse the spine done through the front of the neck can make patients lose their voices. Does it matter which side of the neck the surgeon operates on?

In the past, surgeons typically made incisions on the left side of the neck for this type of procedure. This was to avoid hurting the recurrent laryngeal nerve, or RLN. The nerve takes a more winding path on the right side of the neck, which was thought to put it at increased risk of injury during surgery on the right side of the neck. The RLN connects to the voice box (larynx). Injury to this nerve can cause hoarseness and even vocal cord paralysis.

I am a professional singer who has to have neck surgery. The doctor wants to go in through the front of my neck to join the bones in my spine. Will I lose my voice?

Probably not. In a recent study of 382 operations like yours, only nine patients (2.7 percent) had any hoarseness after surgery. And only two of these patients had problems that lasted more than three months.

MRI Is Not a Fortune Teller

Magnetic resonance imaging--more commonly known as MRI--provides doctors with computerized pictures of tissues inside the body. This machine creates images that look like slices of the area your doctor is interested in. If a person has neck pain, for example, doctors can use MRI to determine exactly where the problem is and where to operate. But can the MRI give an accurate picture of whether the surgery will be a success?

Right or Left? Neck Surgeons Don't Have to Choose Sides

When operating on the spine through the front of the neck, surgeons have to decide whether to make the incision on the right or left side of the neck. It used to be that they went in through the left to avoid hurting the recurrent laryngeal nerve, or RLN.

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