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OAS Health Blog

Management of pinched nerves in the neck.

January 30, 2015

A pinched nerve in the cervical spine is a common problem which can cause significant pain, numbness, and even weakness. There are two main common causes for it: first, a herniation of the intervertebral disk between the vertebrae of the cervical spine (neck) can put pressure on the nerve. Second, gradual wear and tear of the cervical spine, also known as arthritis or degenerative disk disease, can lead to decreased disk space and pinching of the nerve in the window through which it exits the spine and goes to the arm.

Both mechanisms lead to essentially the same symptoms. A good analogy for a pinched nerve is a water hose; just as when you have a foot on the water hose the water can't flow, the signals can't get through a nerve which is pinched. This typically leads at first to pain going shooting down the arm, and eventually can lead to numbness and weakness, which are much more concerning.

Initial treatment of a pinched nerve in the neck in the absence of numbness or weakness is typically physical therapy. If it is not successful, an x-ray guided steroid injection can be tried. If these modalities are not successful, or if signs of nerve damage such as constant numbness or weakness develop, then surgical treatment is reasonable.

Surgery for a pinched nerve in the cervical spine is typically done through the front of the neck, and most of the time can be accomplished with a minimally invasive approach with very small incisions. Once the disk space is identified, the entire disk is removed, and all pressure is removed from the nerve. A fusion can be performed replacing the disc with a carbon fiber spacer which is inserted between the vertebrae and the bones are secured with a thin titanium cage. Alternatively, in selected cases a disk replacement can be performed instead of the fusion.

The surgery usually takes about 1.5-2 hours, and can often be done ambulatory with patients going home the day of the surgery. Success rates are quite high, and most patients have significant relief of their pain by the time they reach the recovery room. This procedure is minimally invasive with complication rates that are very low. If you have signs of a possible pinched nerve from the neck including pain, numbness or weakness, an evaluation with an orthopaedic spine surgeon will enable you to begin the pathway to relief of your symptoms to enable you to resume a full active lifestyle.

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