[Benita]

#4764

I need to have surgery because I have a pinced nerve in my neck. I was thinking about the laser surgery but I am confuse about when the surgeon has to operate is it better for the surgeon to make the incision on the front of your neck with fusion or the back of your neck with the laser. Which is really better or with the laser can the surgeon go in from the front of the neck aswell?

Thank you for your time.

[Donald Corenman, MD, DC]

#4765

If you have a pinched nerve in your neck, it could be from a bone spur (uncovertebral hypertrophy- see web site) or from a herniated disc. The proposed procedures that could relieve your pain include an anterior cervical decompression and fusion (ACDF), placement of an artificial disc (ADR) or a posterior foraminotomy. The website has descriptions of all these procedures.

There are reasons for each procedure. If you have a bone spur causing nerve compression, the ACDF and the ADR generally work better than the posterior foraminotomy for relief. For herniations in the foramen, the posterior foraminotomy works well (as does the other two procedures) and doesn’t require a fusion or replacement.

The laser in my opinion really has no significant place in spine surgery. It sounds very high tech and exciting but all it really does is to simply burn and vaporize tissue. We do the same thing with a small grabber (pituitary rongeur) without the risk of thermal damage to surrounding tissue.

The best choice you can make is not necessarily the procedure itself but a meticulous, well-qualified and experienced surgeon. This surgeon will make the difference between success and failure of the procedure.

Dr. Corenman

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