Neck injuries can cause damage to the part of the spine that runs through the neck---the cervical spine---by pushing spinal discs out of place. If the discs bulge out far enough to touch the nearby nerve roots, patients can experience pain and numbness in the parts of the body connected to those nerves, such as the arms and shoulders. While physical therapy and medications can sometimes be enough to treat mild cervical spine injuries, explains the American Academy of Orthopaedic Surgeons, in more severe cases, surgery is necessary to relieve pressure and get the spinal cord back in proper alignment.
Anterior Cervical Diskectomy and Fusion
Surgeons often operate through the front (anterior) of patients' necks to remove the bulging spinal discs, according to the American Academy of Orthopaedic Surgeons, because such an approach allows them to directly remove all the damaged discs while also fusing two or more vertebrae together with a bone graft to fill the space the discs had previously filled, and to stabilize the spine. The anterior approach also usually relieves neck pain more than the posterior approach does.
Anterior Cervical Corpectomy and Fusion
Doctors remove damaged discs during this type of surgery, as well, but rather than fusing vertebrae together, they remove vertebrae from the injured area and replace it with bone graft material that fuses to the spine, explains the American Academy of Orthopaedic Surgeons. Patients can choose between three different types of bone graft material for either a diskectomy or a corpectomy: autograft material (their own bone, taken from their hips), allograft material (cadaver bone from a bone bank) or artificial bone material. According to the American Academy of Orthopaedic Surgeons, the best choice is to use a patient's own bone, since it is most likely to lead to a successful fusion after the surgery.
Posterior Cervical Laminoforaminotomy
Operating on the injured area from the back of the neck (a posterior approach) often reduces the amount of spinal motion that patients lose from the surgery, states the American Academy of Orthopaedic Surgeons, but it also frequently results in less pain relief than the anterior approach does. When surgeons perform a posterior cervical laminoforaminotomy, they can remove discs without fusing vertebrae together, which can help patients recover more quickly than if they'd had spinal fusion.
Posterior Cervical Laminectomy
In a posterior cervical laminectomy, doctors remove the bony arch (lamina) and any bone spurs and ligaments that are pressing on the spinal cord. Surgeons often also perform spinal fusion with this surgery, according to the American Academy of Orthopaedic Surgeons.
Posterior Cervical Laminoplasty
This type of surgery is an alternative to posterior cervical laminectomy, because it involves hinging the lamina open without completely removing it, according to the American Academy of Orthopaedic Surgeons. Spinal fusion often accompanies this surgery.
