MEDICAL SURFARI: A PAIN IN THE NECK CAN BE CURED

Most of us at one time or another in our life have experienced neck pain. It can be associated with pain across the shoulders, shoulder blades or in the arm and sometimes even involving the hand on one side or both sides of the body. Some people are also troubled by headache associated with their neck pain. The symptoms may appear mysteriously and often for no apparent reason. They may resolve just as mysteriously.

Fortunately most neck aches can be treated non-operatively. Many people respond well to physical therapy that helps to restore the normal mobility of the neck and improve neck posture. However, some people are plagued with constant neck pain that requires the regular use of medication to reduce their pain. Sometimes the pain can be so severe that it makes their life miserable, forcing them to reduce their activities in order to keep the discomfort at a manageable level.

If you have had symptoms of this nature that have lasted for months or even years, you may require further evaluation by a neurosurgeon. Neurosurgeons are specialists in the management of spinal disorders, including those of the neck.

This does not necessarily mean that you will require surgery. Neck surgery is reserved for patients who have a structural lesion as in a herniated cervical disc, or the development of degenerative bone spurs that narrow the opening within the spine for the spinal cord and/or exiting nerves.

Even before the explosion of interest in minimally invasive microsurgical techniques, neurosurgeons began using these techniques in cervical (neck) surgery. The advantages of microscopic technique in spine surgery includes better illumination, magnification and clear stereoscopic vision that permits the precise, meticulous anatomical dissection that is essential in minimizing complications.

When neck surgery is required, most problems can be treated effectively through an incision that is not much more than one inch long, and which may lie in one of the crease lines on the front of the neck. Most patients have little or no discomfort in their neck after surgery and the cosmetic result is often excellent.

Neck problems are often referred to in different ways such as arthritis in the neck, spondylosis of the neck, rheumatism, or a slipped disc. While each of these conditions can cause neck pain, if you have experienced pain and numbness or tingling radiating into your shoulder, arm or hand(s), you may have a condition that requires further evaluation and treatment.

World Wide Web Sites

The American Association of Neurological Surgeons

www.neurosurgery.org/pubpages/patres/cervspnbroch.html

The "Public Pages" section of this site does an excellent job explaining the various aspects of cervical spine disease.

NYU Department of Neurosurgery

mcns10.med.nyu.edu/spine/spine_surgery_p4.html

This site explains the clinical aspects of neck pain along with treatment options.

Wake Forest University School of Medicine

www.bgsm.edu/bgsm/surg-sci/ns/spine.html

This site from the Department of Neurosurgery provides links to information on back and neck injury.

Dr. Scott Gibbs is a Cape Girardeau neurosurgeon and editor-in-chief of Mosby's Medical Surfari. You may e-mail questions to him at drgibbs@semissourian.com or write in care of the Southeast Missourian, P.O. Box 699, Cape Girardeau, Mo., 63701.