The questions people most often arrive with, answered plainly and grouped by where you are in the process. Each answer links to the page that goes into it properly. If your question is not here, it is a reasonable thing to bring to a consultation.
Most settle
The large majority of neck pain and cervical nerve pain improves without an operation.
The exception
Pressure on the spinal cord is the one pattern worth acting on early rather than watching.
Referral
Required for a Medicare rebate. A GP referral is valid for twelve months.
(07) 3870 3708
Reception, Monday to Friday, 8:30am to 4:30pm.
SYMPTOMS
Because a nerve root leaving the neck travels down into the arm, so pressure on it is felt where the nerve goes rather than where it is compressed. That is cervical radiculopathy, and C6 and C7 account for the large majority of it. More about radiculopathy.
It can be. Bilateral hand clumsiness with unsteady walking is the classic pattern of pressure on the spinal cord itself, and it is the one cervical presentation worth acting on early rather than watching. More about myelopathy.
Nothing actually slips. A disc is firmly attached to the bones above and below it. What moves is the soft material inside, which pushes out through or stretches the tough outer ring. More about disc herniation.
Usually not on its own. In an MRI study of 1,211 people with no symptoms, 87.6 per cent had disc bulging. Age-related change in the neck is close to universal, and most people who have it never need treatment for it. More about spondylosis.
The large majority of neck pain episodes improve without injections, scans or surgery. The honest caveat is that recurrence is common, which is a nuisance rather than a danger. More about neck pain.
Weakness that is getting worse, clumsy hands affecting both sides, unsteadiness on your feet, and any change in bladder or bowel control. Those need prompt assessment rather than a wait-and-see. All conditions.
TREATMENT DECISIONS
Less likely than most people fear. More than 85 per cent of acute cervical radiculopathy improves without any specific treatment, most within eight to twelve weeks. Do I need neck surgery?
Where there is no nerve or cord compression, surgery is unreliable for neck pain. Arm pain from a trapped nerve responds well; neck pain alone often does not. The operations explained.
There is no single number, but the natural history is measured in weeks to a few months rather than days. Worsening weakness or any cord sign changes that immediately. Non-surgical treatment.
Both work, and they suit different necks. At seven years, disc replacement showed lower rates of further surgery, but only in patients whose anatomy supported it. Compare the two.
Sometimes. A posterior foraminotomy opens the tunnel a trapped nerve exits through, with no implant and no fusion, where the compression sits in the right place. About foraminotomy.
SURGERY AND RECOVERY
The practice publishes approximately three to five days after a cervical fusion and one to three days after a disc replacement. No separate figure is published for a posterior foraminotomy. Recovery guidance.
The published guidance is that driving is restricted for approximately four to six weeks, depending on how your recovery progresses. Swimming is avoided for four to six weeks. Recovery guidance.
Time away is needed to allow healing, and a temporary return on modified or restricted duties is common. How long depends on the operation and on what your job demands. Recovery guidance.
Considerably, if you are having a fusion. Smoking meaningfully reduces the chance of the fusion setting properly, and stopping is the single most useful thing within your own control. About ACDF.
Less than most people expect. A single fused level takes a small amount of movement out of a neck that has seven, and the remaining levels compensate. Fusion against disc replacement.
Pain usually improves fastest because the pressure is off. Numbness and weakness depend on the nerve repairing, which takes weeks to months, and after long compression some numbness may persist. Recovery guidance.
That is worth saying plainly on a page full of questions about surgery. The large majority of neck pain and cervical nerve pain settles without one, and a consultation is as often about establishing that nothing needs doing as it is about planning something. Pressure on the spinal cord is the exception, and it is the one pattern on this site worth acting on early.
APPOINTMENTS AND COST
For a Medicare rebate, yes. An initial consultation requires a current referral. A GP referral is valid for twelve months; a specialist referral for three months. Request an appointment.
Your referral, past and recent X-rays, scans and laboratory results, your Medicare and health fund cards, and a list of your current medications. Bring the images, not only the reports. Your first appointment.
The practice states that its office will contact you within the next business day. Anything urgent should be phoned through on (07) 3870 3708 during business hours instead. Contact the rooms.
Private surgery generates several separate accounts, and the practice states that a private fee is generally charged for surgery, that a medical gap scheme applies in some circumstances, and that estimates and payment plans are available. Costs and fees.
Telehealth consultations are available to patients residing in Medicare-approved regions. A video appointment covers history and imaging well, but not the physical examination. How telehealth works.
Dr Tollesson consults and operates at Greenslopes Private Hospital and the Queensland Children's Hospital. About the hospitals.
NEXT
Six cervical conditions explained from the symptom rather than the name, with what usually causes each and what tends to help.
All conditions ›What has to be true before surgery belongs in the conversation, and the signs that change the timing.
Work through it ›One short form, or a phone call to reception. What you need in order to be seen, and what to have ready.
Go to the form ›This page summarises answers set out in full elsewhere on this site. It is general information about the cervical spine, not a substitute for an assessment of your own neck. Where figures are given, they come from the published research listed below.
References
Abnormal Findings on Magnetic Resonance Images of the Cervical Spines in 1211 Asymptomatic Subjects. Spine, 2015, for what imaging shows in people with no symptoms.
Cervical Radiculopathy, StatPearls, National Library of Medicine, for the natural history of nerve root pain and the levels involved.
Cervical disc arthroplasty versus anterior cervical discectomy and fusion: a meta-analysis of rates of adjacent-level surgery to 7-year follow-up. Journal of Spine Surgery, 2020, for the comparison between the two operations.
A Clinical Practice Guideline for the Management of Degenerative Cervical Myelopathy, AO Spine and the Cervical Spine Research Society, for the guidance on spinal cord compression.
A consultation will tell you what is causing your symptoms, whether anything needs treating, and what the options are. A GP or specialist referral is needed for a Medicare rebate.