Neck Pain

Neck instability and cervical spine surgery

November 10, 2016 – Marc Darrow MD, JD

neck painWhy do so many patients get neck surgery? One reason is fear that their symptoms and neck instability will progress and doctor may say “paralysis risk.”

Doctors at the Medical College of Hallym University, South Korea published findings to the contrary:  “Our results suggest that the majority of these patients may be stable and do not develop progression of disease or catastrophic neurologic deficits.”1

Neck pain is one of the common problems we see. That’s because our patients are not in a rush to have a surgery that some doctors suggest is not necessary.

Doctors at the Rothman Institute, Thomas Jefferson University and Hospitals found: “With many surgeons expanding their indications for cervical spine surgery, the number of patients being treated operatively has increased. Unfortunately, the number of patients requiring revision procedures is also increasing, but very little literature exists reviewing changes in the indications or operative planning for revision reconstruction.”2

What these researchers are saying in their study is that doctors have broadened the criteria for neck surgery so more can be justified. However, the literature is not keeping up with ways to help the increasing new group of failed neck surgery patients.

Compounding this is the always present rush to surgery spurred on by MRI. Doctors at Yale University suggested to doctors not to solely rely on MRI readings when evaluating patients for neck pain treatment:  “Physicians should be aware of inconsistencies inherent in the interpretation of cervical MRI findings and should be aware that some findings demonstrate lower agreement than others (in recommending surgery).”3

There are a number of ways to incur a neck injury, which damages the tendons and ligaments around the joints of the neck. Alternative symptoms associated with this type of damage can include headaches, jaw pain, ear pain, vertigo, loss of voice or hoarseness, and even irritable bowel syndrome. Some of the symptoms can often be alleviated with Stem Cell Therapy, PRP, or prolotherapy injections.

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1. http://wolterskluwer.com/company/newsroom/news/health/2013/02/degenerative-cervical-spine-disease-may-not-progress-over-time.html

2. Helgeson MD, Albert TJ. Surgery for Failed Cervical Spine Reconstruction. Spine (Phila Pa 1976). 2011 Nov 8. [Epub ahead of print]

3. Fu MC, Webb ML, Buerba RA, et al. Comparison of agreement of cervical spine degenerative pathology findings in magnetic resonance imaging studies. Spine J. 2016 Jan 1;16(1):42-8. doi: 10.1016/j.spinee.2015.08.026. Epub 2015 Aug 17.