Cervical Spine / Neck Surgery

Surgery in the cervical spine area is usually needed to treat the following conditions.


Trigeminal neuralgia

Trigeminal neuralgia affects the nerve that carries facial sensations such as pain, pressure and temperature to the brain. It is caused by damage to the protective sheath that insulates the nerve.

Symptoms

Symptoms include a sharp shooting pain, usually on one side of the jaw.

Diagnosis and Treatment Options

We will conduct a neurological examination to determine the location and cause of the pain. An imaging study such as an x-ray, computed tomography (CT) or magnetic resonance imaging (MRI) scans may help us examine the trigeminal nerve and its branches and identify a tumour or other causes of pain.

Treatment usually involves medications such as anticonvulsants, muscle relaxants, anti-seizure or antidepressant drugs. If these are ineffective, glycerol may be injected at the root of the nerve. Microsurgery or radiosurgery can shift or remove the blood vessels or tissue causing damage to the trigeminal nerve.


Whiplash

Whiplash is an injury to the soft tissue of the neck, usually caused by a sudden jerk in a car accident, sports injury or fall.

Symptoms

The most common symptoms of whiplash are stiffness in the neck, neck pain and headache. Other symptoms include stiffness, dizziness, tingling sensation in the upper body, memory loss, anxiety, depression and sleep disturbances.

Diagnosis and Treatment Options

We will usually take an x-ray to make sure there are no fractures or dislocation of the cervical spine. We might need to prescribe pain medications and muscle relaxants. You will need to wear a cervical collar and rest. To manage symptoms we might recommend neck exercises as well as use of heat and cold packs.

Recovery

Physiotherapy, rest, neck brace, time to heal. Generally surgery is not required for whiplash.


Von Hippel-Lindau Disease (VHL)

Von Hippel-Lindau Disease (VHL) is a rare genetic disorder that causes benign and cancerous tumours in the blood vessels in the brain, spinal cord and eyes. Cancers may also develop in other parts of the body such as the kidneys, pancreas and adrenal glands.

Symptoms

The symptoms of VHL vary depending on the location of tumours. Patients might experience headaches, dizziness, problems with balance, pain, weakness, difficulties with vision and high blood pressure.

Diagnosis and Treatment Options

To diagnose VHL, we will usually evaluate your medical history, signs and symptoms, and do a physical and neurological examination. If you have a family history of VHL but no symptoms, we might recommend a DNA test. We will also examine your eyes and suggest diagnostic tests such as x-rays, computed tomography (CT) or magnetic resonance imaging (MRI) scans to identify the characteristic tumours or other abnormalities.

Treatment depends on the size and location of the tumours and the symptoms. Some tumours can be monitored on a periodic basis and treated when needed. Large tumours that compress areas such as the brain, spinal cord and eye are removed by surgery or radiation. Cancers caused by VHL in other parts of the body are treated by surgery.

Recovery

If surgery is required the following is a general recovery overview.

Your neck will most likely feel stiff or sore and you may find it hard to sit still for long periods. It might be difficult to lift and bend without straining your neck and back and causing pain. Pain medication will usually be prescribed.

Recovery differs between patients and surgeries.  As a general guide the following are consistent with all cervical surgeries:

  • Three to five days in hospital
  • No heavy lifting for the first few weeks or so (and graduated lifting restrictions thereafter)
  • Some time off work in order to recover
  • You may need to return to work on restricted duties for a period of time
  • You may not be able to drive for 4 to 6 weeks
  • No swimming for 4 to 6 weeks
  • Physiotherapy
  • Pain medication
  • Rehabilitation depending on the surgery

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