Relief for a Pinched Nerve in Your Neck
When a worn or herniated disc in the neck is pressing on a nerve or the spinal cord, removing it can often correct the problem, relieving arm pain, numbness and weakness.
What Is a Cervical Discectomy?
A cervical discectomy is a surgery that removes a damaged disc in the neck, along with any disc material or bone spurs pressing on a nerve root or the spinal cord. Your neck, or cervical spine, has seven vertebrae with a cushioning disc between most of them. When a disc herniates or wears down, it can pinch the nerves that travel to the shoulders, arms and hands, or press on the spinal cord itself.
A cervical discectomy is almost always done as part of a larger operation, because once the disc is removed, the space between the vertebrae needs to be supported. Dr. Grunch tailors the approach to your anatomy:
- Anterior cervical discectomy and fusion (ACDF): the disc is removed through the front of the neck, and the space is filled with a spacer and bone graft so the two vertebrae heal together.
- Cervical artificial disc replacement: the disc is removed through the front of the neck and replaced with an artificial disc that keeps the level moving.
- Posterior cervical microdiscectomy and foraminotomy: for a disc herniation off to one side, the fragment can sometimes be removed through a small incision in the back of the neck, without a fusion or implant.
Who Needs a Cervical Discectomy?
- Arm pain, numbness, tingling or weakness from a pinched nerve (cervical radiculopathy) that hasn’t improved with conservative treatment
- Signs of spinal cord compression (cervical myelopathy), such as clumsy hands, trouble with buttons, or feeling unsteady when walking
- Weakness that is getting worse
- An MRI showing a herniated disc, bone spurs or disc degeneration that matches your symptoms
Call 911 or go to the nearest emergency room if you have sudden weakness in your arms or legs, sudden trouble walking, or new trouble controlling your bladder or bowels.
Treatments to Try First
- Physical therapy: neck and upper back strengthening, posture work and traction
- Medications: anti-inflammatory medications, short courses of oral steroids or nerve pain medications
- Injections: cervical epidural steroid injections or nerve root blocks
Many pinched nerves in the neck improve with time. When pain persists, or there is weakness or spinal cord compression, surgery can often correct the problem.
How a Cervical Discectomy Is Done
From the front of the neck (ACDF or disc replacement)
- Anesthesia: You’ll be fully asleep, lying on your back.
- A small incision: Dr. Grunch makes a small horizontal incision in a natural skin crease on the front of the neck.
- Gentle access: The windpipe and esophagus are gently moved to one side. No muscles are cut.
- Removing the disc: Using a microscope, the entire disc is removed, along with bone spurs and disc fragments pressing on the nerves or spinal cord.
- Supporting the space: A spacer and bone graft are placed for a fusion, or an artificial disc is placed to preserve motion.
- Closing: The incision is closed with dissolvable stitches and skin glue, usually leaving a small, faint scar.
From the back of the neck (posterior microdiscectomy)
Through a small incision in the back of the neck, a small window of bone is opened and the herniated fragment is removed from beside the nerve. This approach works best for soft disc herniations off to one side and doesn’t require an implant.
This animation shows how a posterior cervical foraminotomy is performed:
Posterior cervical foraminotomy animation, courtesy of Swift Institute
Benefits and Risks
Benefits
- Relief of arm pain for most patients, often soon after surgery
- Protection of the spinal cord when it is being compressed
- Options that preserve motion when you’re a good candidate
Risks
- Temporary sore throat, trouble swallowing or hoarseness after a front-of-the-neck approach
- Infection or bleeding
- Nerve or spinal cord injury, which is rare
- Spinal fluid leak
- Wear at neighboring levels over time
- Risks related to anesthesia
Why Choose Dr. Betsy Grunch for Your Cervical Discectomy
- Duke-trained: Dr. Grunch completed her neurosurgical residency and a spine research fellowship at Duke University School of Medicine, one of the top neurosurgery programs in the country, where she received the Spine Young Investigator Award.
- Motion-preservation expertise: Cervical and lumbar artificial disc replacement are among her signature procedures, so fusion isn’t your only option.
- Experience you can count on: She has been in practice since 2013 and performs 400 to 600 surgeries a year, more than 5,000 procedures over her career.
- Second opinions and revisions: She regularly sees patients who had spine surgery elsewhere and want a second opinion or need a revision.
- A teacher at heart: As “Ladyspinedoc,” she is known for explaining spine conditions clearly. You’ll leave your visit understanding your imaging and every option in front of you.
What to Expect
Before surgery
You’ll meet with Dr. Grunch or one of her physician assistants to review your imaging, your exam and your goals, and to decide together whether a cervical discectomy is right for you. Our team will coordinate any pre-operative testing, review your medications (including blood thinners you may need to pause) and walk you through the day of surgery so nothing is a surprise. If you smoke or use nicotine, stopping before surgery lowers the risk of complications.
Procedure day
Surgery usually takes one to two hours per level. Many patients go home the same day, and some stay one night in the hospital. Your care plan will depend on whether you have a fusion, a disc replacement or a posterior microdiscectomy.
Recovery timeline
- First two weeks: Arm pain often improves quickly. A sore throat and trouble swallowing are common after a front approach and improve over several weeks.
- Two to six weeks: Gradually increase your activity. Many people return to desk work in two to four weeks.
- Six weeks and beyond: Most patients return to normal activities. Numbness and strength can keep improving for several months.
Every patient heals differently. Your exact timeline will depend on your symptoms, your job and your overall health.
For detailed instructions, see the ACDF and cervical disc replacement pages, which include downloadable patient sheets, or visit our Patient Resources page.
Frequently Asked Questions
Will I need a fusion?
Not always. Depending on your anatomy, Dr. Grunch may recommend a disc replacement, which preserves motion, or a posterior microdiscectomy, which needs no implant. A fusion is recommended when it gives you the best chance of lasting relief.
Why go through the front of the neck?
Most cervical discs are reached most directly and safely from the front, through a natural space between the muscles. This lets the surgeon remove the whole disc and anything pressing on the spinal cord without disturbing the back-of-the-neck muscles.
Will I have a big scar?
The incision on the front of the neck is usually small and placed in a natural skin crease, so it often fades to a faint line.
Can I turn my head after surgery?
Yes. Most people keep good neck motion, especially after a one- or two-level surgery.
When can I drive?
You may drive once you’re off narcotic pain medication and can turn your head comfortably, usually within one to two weeks.
Take the First Step Toward Relief
A pinched nerve in the neck can make it hard to work, sleep or use your hands. Whether you need a treatment plan, a second opinion or a clear explanation of your imaging, Dr. Grunch and the Southern Neurosurgery team are here to help.
Call 470-293-9800 to schedule an appointment or contact us online.
Have a question first? Ask our virtual assistant anything, 24/7.
We see patients across metro Atlanta and North Georgia at our offices in Gainesville, Sandy Springs and South Atlanta (Riverdale). Find the office nearest you.
Related pages: Cervical radiculopathy · Cervical myelopathy · ACDF · Cervical disc replacement · Foraminotomy
This page is for educational purposes only and is not medical advice. It does not replace individualized care from a licensed physician. Please talk with your own doctor about your symptoms. If you have sudden weakness, trouble walking, or new bladder or bowel problems, call 911 or go to the nearest emergency room.