Neck Injury Treatment

Neck injury treatment can be "conservative" or involve surgery.

Conservative Treatment

Conservative treatment can include medications to relieve your pain and to relax your muscles, perhaps a cervical collar to support your neck while it is healing, or a cervical pillow to help you sleep.

Your doctor may order physical therapy to help hasten your recovery and to prevent further injury.

Perhaps your doctor will do one or more epidural steroid injections (Nerve Blocks) as part of your neck injury treatment. This places a small amount of cortisone -- a strong anti-inflammatory medicine -- into the spinal canal to ease the pain caused by irritated nerve roots.

Surgery

Surgery is only necessary in a relatively small number of cases.

When it is necessary, neck surgery is done by an orthopaedic surgeon or by a neurosurgeon, or by both working together, who usually do one of the following operations . . .

Discectomy. Discectomy means "removal of the disc." The purpose is to remove the pressure on a nerve root by removing the herniated disc that is causing the pressure.

In the neck, this is almost always done from the front. An incision is made in the front of your neck right beside your trachea (windpipe). The muscles are moved to the side. The arteries and nerves in the neck are identified and protected.

Once the spine is reached, each disc and vertebra is identified using an x-ray. This is to make sure that the right disc is being removed. The surgeon then removes the disc. Of course, great care is taken not to damage the spinal cord and the nerve roots.

In the cervical spine, a discectomy is usually combined with a fusion.

Cervical Fusion. In this procedure, the surgeon fills the space left by removing the disc with a block of bone, usually from a donor site in the hip.

A small incision is made in the hip and a suitably sized piece of bone is removed. The surgeon then places this bone graft between the two vertebrae so that the two bones can grow together, or fuse.

As mentioned, this type of fusion is much more commonly done from the front. Occasionally, however, there may be a posterior fusion, usually for fractures of the spine.

When doing a cervical fusion, the bone graft may simply be wedged in between the vertebrae. However, surgeons are increasingly using "instrumentation" to help hold the graft in place. Most commonly, metal plates and screws are used to hold the bones in place while the fusion heals.

Laminectomy. Some conditions, including spinal stenosis, require that the spinal canal be made larger. One way that this is done is by a complete laminectomy. Laminectomy means "remove the lamina," which is the back side of the spinal canal which acts as the roof over the spinal cord. Removing the lamina gives more room for the nerves. In the neck, surgeons may also do a partial laminectomy, removing only part of the lamina.

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