When chronic neck pain doesn’t respond effectively to conservative care measures like rest, activity modification, postural correction, physical therapy, chiropractic care, massage, or cervical epidural steroid injections, it may be time to consider your surgical treatment options.

As with chronic back pain, there’s a wide array of spine conditions that can lead to severe and persistent neck pain problems. In most cases, intense neck pain is a product of degeneration in the cervical spine that compresses the spinal cord and nerve structures, gives rise to abnormal spinal motion, or both.  

Accordingly, surgery to treat severe neck pain is usually done to decompress a nerve root, decompress the spinal cord, stabilize the cervical spine, or any combination of the three. 

At Steel City Spine and Orthopedic Center, board-certified spine and orthopedic surgeon Dr. Jocelyn Idema uses advanced, minimally invasive techniques to help resolve severe neck pain, improve function, preserve motion, and ensure stabilization. Here, she discusses five of the most common cervical spine surgeries for chronic pain.   

1. Discectomy and fusion

A high percentage of persistent neck pain problems are caused by disc degeneration in the cervical spine. As such, the most common surgery for neck pain involves a discectomy, or the removal of a severely degenerated spinal disc through a cervical discectomy. This procedure is done in conjunction with a cervical spinal fusion to preserve spinal stability where the disc was removed.

This technique can also be done without a spinal fusion, providing the problematic spinal disc is only partially damaged. In such cases, only the damaged portion of the disc is removed; the rest remains intact for continued spinal stability. 

2. Artificial disc replacement

As a back and neck pain specialist who strives to provide the best possible outcome with every spine surgery she performs, Dr. Idema goes beyond the conventional cervical discectomy and fusion approach with a next-level technique called cervical artificial disc replacement surgery.

Like a cervical discectomy and fusion, this technique removes a severely degenerated spinal disc that’s causing persistent pain. But rather than fusing the adjacent vertebrae for stability once the disc has been removed, Dr. Idema replaces the damaged disc with an artificial one, effectively eliminating the need for a fusion. 

This revolutionary approach preserves normal spinal motion, helping you retain the natural flexibility in your neck that might otherwise be lost if your vertebrae were fused together. 

3. Foraminotomy or laminotomy

Cervical spinal disc herniation and bone spurs are two other common causes of severe, ongoing neck pain. In such cases, the primary surgical goal is decompression, either by removing the tissue that’s pressing against the nerve or spinal cord, or by creating more space for the nerve tissue to remain unobstructed. 

The foramen is the bony, hollow passageway that your spinal nerve roots run through as they extend from your spinal cord to your organs, muscles, and sensory structures. If intervertebral disc material or a bone spur is pressing on a nerve as it exits through the foramen, Dr. Idema performs a foraminotomy procedure to make the opening of the foramen larger, so the nerve can exit without being compressed.

Similar to a foraminotomy, a laminotomy involves making a hole in the lamina — or the bony posterior “roof” of the spinal canal which supports and protects the spinal cord — to effectively create more space for the spinal cord and decompress affected spinal nerves. 

4. Laminectomy or laminoplasty 

A laminectomy removes the lamina — in whole or in part — to reduce pressure on your spinal cord and nerves. Any discs, bone spurs, or ligaments that are contributing to compression may also be removed. Because removing part of the vertebra in your cervical spine can make your neck less stable, a laminectomy is often done in conjunction with a spinal fusion. 

As a motion-saving alternative to laminectomy, a laminoplasty shapes the lamina to create more room for the spinal cord and alleviate severe neck pain. With this approach, Dr. Idema creates a door-like hinge to open up the lamina and decompress the spinal cord. She inserts metal implants to keep the hinge in place. Laminoplasty allows Dr. Idema to address multiple areas of compression while preserving cervical range of motion — no spinal fusion needed.  

5. Vertebroplasty or kyphoplasty 

If your severe neck pain is a product of osteoporosis-related compression fractures in your cervical vertebrae, Dr. Idema may be able to effectively treat the problem with a minimally invasive in-office procedure — either vertebroplasty or kyphoplasty. 

To perform an in-office vertebroplasty procedure, Dr. Idema uses imaging guidance to inject a cement mixture into the fractured bone; with kyphoplasty, she first inserts a balloon into the fractured bone to create space, and then fills the space with cement. These techniques alleviate compression-related neck pain and restore lost mobility so you can become more active once again.  

Don’t let severe neck pain stop you from living your best life — call or click online to schedule a consultation with Dr. Idema at Steel City Spine and Orthopedic Center today. We have office locations in Pittsburgh, McKees Rocks, and Washington, Pennsylvania.