Surgery

Surgery is rarely needed for neck pain. It may be an option when:

• A neck injury causes a fracture or abnormal motion (instability). Surgery may be done to stabilize the spine and prevent a bone fracture from causing instability and possible paralysis.
• Pressure on the nerve roots or spinal cord causes numbness or arm, hand, or leg weakness; severe pain that lasts for months; or loss of bladder or bowel control.³
• You have a narrowing of the spinal canal (cervical spinal stenosis).
• You have arthritis of the neck (cervical spondylosis).

Surgery choices

• Discectomy (with or without fusion). The surgeon removes herniated disc material that is pressing on a nerve root or the spinal cord.
• Cervical spinal fusion. Selected bones in the neck are joined (fused) together.
• Spinal decompression. Pressure is reduced on the spinal cord or spinal nerve roots by removing part of a bone or disc.

Some people can consider artificial disc replacement instead of spinal fusion. This surgery is currently just for carefully selected patients, and it is done by specially trained surgeons. Doctors have not yet done long-term studies to know how well this works over time.

Some people with chronic facet joint pain have a surgery called percutaneous radiofrequency neurotomy. The facet joint is a portion of the spine in the neck that is sometimes responsible for neck pain after whiplash. One review suggests that this surgery offers short-term relief for chronic neck pain. Almost 60 out of 100 people with whiplash said they were pain-free more than 6 months after treatment.² That means the surgery did not get rid of the pain in 40 out of 100 people. And the pain will most likely come back over time.