Pain and numbness in areas like the arms and shoulders can signal damage to the cervical spine, which runs through the neck. Damaged spinal discs can bulge out of their proper places in the cervical spine, touching nerve roots nearby and triggering pain and numbness. Bone spurs can cause similar problems. Sometimes patients with cervical spine damage require surgery to relieve nerve pressure and stabilize the spinal cord.
Anterior Approaches
Operating on the cervical spine through the anterior, or front, of a patient's neck, a surgeon can completely remove bulging discs or bone spurs through anterior cervical fusion surgery. Then, after removing the material that has caused problems, the surgeon fill the spaces left behind with bone grafts---either a patient's own bone, a bone from a cadaver, or artificial bone---to stabilize the spine. The best choice for a bone graft, according to the University of Maryland Spine Program, is a patient's own bone, since that is most likely to result in successful fusion after the surgery.
Posterior Approaches
Sometimes surgeons operate on the cervical spine through the posterior, or back, of a patient's neck, especially if the channel that houses the spinal cord has narrowed, says MayoClinic.com. Posterior cervical fusion has the same goal as the similar anterior cervical fusion surgery: removing damaged material like discs and then using bone grafts to fill the spaces left behind and stabilize the spine. Posterior cervical laminectomy involves removing bone and possibly ligaments that are pressing on the spinal cord. Posterior cervical laminoplasty, which MayoClinic.com says is an alternative to posterior cervical laminectomy, involves creating more room for the spinal cord by cutting and moving pieces of vertebrae. Laminoplasty is less likely than laminectomy to leave the neck unstable.
Cervical Corpectomy and Strut Graft
Working either through the front or the back, surgeons can remove both the discs and the vertebral bodies themselves that are putting pressure on the spinal cord. This procedure is called a cervical corpectomy. The University of Maryland Spine Program says that a corpectomy is most often performed with an anterior approach in the cervical spine, although it can be performed through the back. After doctors remove the material that has caused spine problems, they then usually fill the space with a structural graft called a "strut graft." Sometimes doctors can use a patient's own bone taken from the leg, or a cadaver bone from a bone bank. While a patient's spine is healing, something is necessary to hold the remaining vertebrae and bone graft in place, and that usually involves using a metal plate with screws to connect the vertebrae and graft.
