According to the Boston Globe early this month, football superstar Peyton Manning just had surgery in Chicago for a pinched nerve in his neck.  While the details of his condition were not released, surgeons at our Spine Center say they routinely see patients for this kind of problem and there are a variety of treatment options.

The nerves that get “pinched” in the neck are usually the large nerve roots that exit the spine through bony tunnels between the vertebrae.  These nerve roots progressively branch out allowing us to move and feel our arms.  Pressure on the nerve roots can cause numbness, tingling, and pain in the neck, arm or hand.

The cause and exact location of a pinched nerve is usually determined by neurological examination and an MRI.  If the problem is new, surgeons usually won’t operate until a course of rest, medications, and physical therapy have been tried.  When the problem persists like it reportedly did for Manning, there are surgical treatments to consider.  The type of surgery done depends on what is causing the problem, where it is, and the extent of the damage.

The most common cause of a pinched nerve is Herniated Intervertebral Disc Disease.  The intervertebral disc is a cushion that sits between the bones of the spine.  With wear and tear, the fibrous outer ring of the disc can become cracked or thinned and the jelly like interior can bulge out or protrude onto nearby nerve roots.

If the disc is the culprit, then something as simple as a Microdiscectomy can be performed.  Here, surgeons remove the offending portion of disc through a small incision in the back of the neck.  The surgery is minimally invasive and the patient often goes home the next day.

When the disc has degenerated more significantly as in Spinal Disc Disease, surgeons may need to remove it altogether.  This surgery, called an Anterior Cervical Disectomy and Fusion/Fixation, is much more involved.  Surgeons operate through the front of the neck, removing the entire disc and some of the bone.  The disc is replaced with a spacer and the whole area is secured with plates and screws.

More recently surgeons have begun to use artificial disc replacements, a surgery that preserves the movement of the neck.  The Spine Center is currently involved in clinical trials for the SECURE®-C Cervical Artificial Disc.

You can’t always blame the disc, however.  The nerve can be pinched because the bony tunnel, or foramen, through which it exits the spine has narrowed with age.  When this is the case, surgeons can perform a laminectomy, where they remove the part of the bone that is crowding the nerve.

Peyton Manning was not treated here at the Spine Center, and while we can’t officially comment on his status, it looks like his surgery went well.  According to the Globe article, he was released from the hospital the day after surgery and,”‘All medical personnel involved believe the issue has been resolved,’ the team said. ‘Peyton fully expects to participate in the Colts’ offseason program this spring.’”