1. The Procedure Fits the Problem
Because there are several problems that can occur in the neck area, once identified and the need for surgery is established, the surgical procedure is chosen in specific relationship to the pathology needing correction. Cervical spine pain and pathology typically requires procedures that are performed either through anterior or posterior neck incisions. For a bony overgrowth and stenosis problems, the posterior approach is often preferred. For disc procedures, the anterior approach is used. Other procedures typically used for neck pain complaints and pathologies can include thyroidectomy/parathyroidectomy and carotid endarterectomy.
2. Understand the Limitations of the Procedure
Regardless of the approach, length of surgery and expected results, these procedures have very definite limitations. For example, removing pressure from damaged nerve tissue is no guarantee the nerve tissue will regenerate. Removal of an arthritic joint offers no concrete guarantee of freedom from pain, nor is either procedure capable of fixing what is already permanently damaged. Understand the problem and intended solutions, but maintain realistic expectations.
3. Anterior Approach Procedures for Cervical Spine Pain
Surgical procedures involving the softer tissues of the neck are typically performed through an anterior incision. Procedures utilizing this approach include the thyroidectomy, parathyroidectomy, carotid endarterectomy and tracheotomy, as well as certain cancer related procedures. There are inherent risks to this approach because of the close proximity of vital vascular structures, the airway and nerves that control the vocal cords, which, when damaged, can result in partial or complete loss of voice.
4. Be Aware of the Potential for Postoperative Complications
In all surgical procedures of the neck, there are risks and potential complications that could occur after surgery.
When performing surgical procedures of the neck from a posterior perspective, there are risks not only of intra-operative injury or damage to the spinal cord and nerves, but also injury and damage to the vital structures from bleeding and swelling even after the surgery.
For procedures done through anterior neck incisions, the risk of swelling and bleeding is equally present. Because of the supple nature and amount of soft tissue located in the anterior neck, it can be difficult to identify postoperative bleeding or swelling until it has become severe, when it can threaten speech and breathing.
5. Know What to Expect in the Long Term
The purpose of neck surgery, as with all surgical procedures, is to make the problem better. That is not to say, however, that neck surgery will make you completely normal. In fact, while results of most neck surgical procedures are extremely good, the possibility of some level of chronic pain or stiffness is a very real one.
It is extremely important to be well educated about the problem, solutions and potential risks of any treatments for neck pain. It is with this knowledge that informed decisions can be made.
