Improvements in technology and the selection process for surgical candidates have led to the relatively high success rates for cervical spine surgeries. Compared to a few decades ago, doctors have better data regarding what surgery for cervical degenerative disc disease symptoms can and cannot accomplish, and which types of patients are most likely to experience a satisfactory outcome.
Who May Be a Good Candidate for Surgery?
The following factors may indicate that a surgery may be a reasonable option for someone with cervical degenerative disc disease:
- A correctible spinal problem has been identified. An MRI or other imaging method must confirm spinal degeneration at the vertebral level that corresponds to the pain symptoms. For example, if a herniated disc and bone spur are compressing the C7 nerve root on the same side of the body that has arm pain and numbness, it is likely that surgery to remove that disc and bone spur can relieve pressure on the nerve root enough for the symptoms to subside.1
- Neck pain symptoms are significantly reducing quality of life. When pain and other symptoms go beyond a fitful annoyance and start consistently interfering with daily tasks, such as performing job duties, enjoying hobbies, getting enough restorative sleep, or even simply getting dressed, the potential benefits of surgery may start to greatly outweigh the procedure’s costs and potential risks.
- Pain has lasted at least 6 months despite trying nonsurgical treatments. For chronic neck pain, it is typically recommended to try nonsurgical treatments for at least 6 months. It may take several months before finding the right combination of treatments that work best for the patient. Sometimes neck pain—even severe pain that travels into the arm—may go away on its own after many months.2 However, if symptoms of arm weakness or numbness are worsening or severe, or difficulty with walking, coordination, or bowel and bladder control are present, surgery may be recommended much sooner than 6 months.
- Patient is motivated to have surgery. Even if a person appears to be a good candidate for surgery, this type of procedure is almost always elective and up to the patient. Patients who smoke may be required to quit smoking (or any form of nicotine intake) before having the surgery. It is important to make a commitment to follow the surgeon’s treatment plan and months-long recovery process.
In addition, in certain situations it may make sense to get a second opinion before agreeing to a major surgery.
When Surgery Should Be Delayed or Avoided
Even with significant amounts of neck pain, the vast majority of cervical degenerative disc disease cases do not need surgery to manage or alleviate symptoms. Some indications of when surgery is not yet needed or advised include:
- Absence of symptoms that would suggest nerve root compression, such as pins-and-needles tingling, numbness, and/or weakness radiating into the arm, or spinal cord compression, such as difficulty with coordination, walking, and/or bowel or bladder control.
- Symptoms that are managed well enough with nonsurgical treatments to have a good quality of life, including the ability to work as desired, sleep well through the night, and enjoy favorite activities.
- Symptoms that have lasted less than a few months.
Delaying or avoiding surgery for cervical degenerative disc disease is almost always a reasonable option. However, if symptoms of nerve root or spinal cord compression have worsened to the point of causing significant weakness or coordination problems, surgery will likely be strongly recommended in order to reduce the risk of permanent nerve damage from occurring or becoming worse.