Compression of a spinal nerve root in the neck causes severe pain radiating into the arm. Pain also occurs in the neck and shoulder blade. There may be associated sensation of numbness, perhaps even weakness in the arm and hand. The cause of the compression is often a bulging or herniation of intervertebral disc material which migrates into the spinal canal, compressing the nerve root. An over growth of adjacent bone, osteophytes, are also a common cause of nerve root compression. On rare occasions the spinal cord may be compressed causing instability in walking, weakness and numbness in the arms and legs.

Surgical treatment for cervical nerve root pain is quite successful. Decompression of the nerve is performed either through an approach from the back of the neck or through a small incision in the front of the neck. Although both surgical approaches are equally effective, the anterior approach is much less painful.

A side view x-ray showing the bone graft between the fourth and fifth neck vertebrae. The arrow points to the titanium plate.

A small incision in the front of the neck is made under general anesthesia, and through an operative microscope the offending central disc material is removed, including any bone spurs compressing the nerve root or spinal cord. A small bone graft is placed into the empty disc space. The graft obtained from the patient’s pelvic rim or, more usually, from a bone bank. Modern, processed banked bone is safe and avoids the pain of an additional incision. Usually a small titanium plate is used to fix the graft in position. The procedure takes about one hour. Many individuals may go home the next day. There is no appreciable blood loss and no cervical brace need be used. Probably 85% to 95% of selected patients will be relieved of neck and arm pain. Individuals will return to every day activities quickly.