Failed neck surgery syndrome is when neck or arm pain persists despite undergoing cervical spine surgery. There are many reasons for patients to have continued pain after neck surgery. The only way to determine the cause is through a detailed review of past symptoms, surgeries, and current symptoms to rule out other causes of pain and a thorough physical exam with imaging.

With an exponential increase in neck surgeries being performed every year, spine surgeons are now seeing increasing numbers of patients with failed neck surgery syndrome. The role of the spine surgeon in the evaluation of failed neck surgery syndrome is to determine whether there is any structural and possibly correctable reason for the pain.

Chronic pain after neck surgery can be related to a host of factors, including biologic, social and psychological factors. Possibly correctable causes of persistent pain after neck surgery may be incomplete decompression of the spinal cord or nerves during the last surgery, non-union, or misalignment. Additionally, there may be signs of a new problem such as adjacent segment disease (degenerative changes of the spine bones around the fusion), or another disc herniation that appears after surgery.

• Neck pain
• Shooting arm pain
• Numbness or tingling in the arm
• Weakness of the arm

The diagnostic work-up for failed neck syndrome is aimed at understanding the patient’s history of neck problems, past treatments, surgeries, postoperative course, and current anatomy and symptoms. A physical exam will help determine current symptoms of pain, numbness, tingling and weakness. Certain patterns of pain and other symptoms may point to compression of a specific nerve. Imaging studies include:

• X-rays from different views to assess alignment.
• MRI (if there is no spinal hardware) to check for structural abnormalities around the discs and nerves.
• CT (if there is spinal hardware) allows imaging of the bone to assess whether the fusion has healed or if a prior disc replacement device has been properly placed.

Failed neck surgery syndrome can sometimes be a result of unrealistic expectations of what surgery can do. It is important for surgeons and patients to have honest discussions before surgery is done as to how much improvement a patient may be able to expect with surgery.

Failed neck surgery syndrome is a challenging condition. If you or a loved has neck pain after neck surgery, contact Chicago spine surgeon Dr. Kern Singh who can assess your situation, provide an accurate diagnosis and guide you on the most suitable treatment options.