The initial assessment of patients with neck pain should include evaluation for spinal nerves and spinal cord compression. Many patients report neck pain that travels, or radiates, into one arm and often extends into the hand causing an achy or cramp-like feel. If the nerve compression is severe, this pain can also be accompanied by weakness or numbness in the arm. Similar to the lower back pain, many people suffer from episodes of neck pain in their lifetime that may not be a sign of compromised nerves. Often a spine specialist, such as a neurosurgeon, can help to establish the correct diagnosis.

For patients with neck pain and possible nerve compression, initially conservative therapy is recommended. This typically consists of physical therapy and the use of non-steroidal anti-inflammatory medications. If the patient continues to experience pain then an imaging study is usually the next step. This can help to identify any structural abnormalities (for example, cervical disk herniation) as the cause of the pain.

Patients with neck problems that continue to bother them despite therapy often require surgery. For patients with disk herniation, many will improve with time. Surgery is reserved for those patients with incapacitating or persistent pain and signs of nerve root injury, such as weakness or numbness.

ACDF is a surgical technique designed to relieve compression on the cervical spine nerve roots and spinal cord. First, the disk is removed, thereby decompressing the nerves and allowing them to heal. A small graft is then placed between the bones, or vertebrae, after the diskectomy is completed. Finally, a small plate is secured with screws to stabilize the vertebrae on either side of the disk space. This reduces motion between the vertebrae thus facilitating the fusion process.

Patients undergoing this procedure are often discharged the day after surgery. Most are able to carry out their daily routines without assistance.

This surgical procedure, known as a decompressive laminectomy, is designed to relieve compression on the nerve roots and spinal cord from a posterior or back side of the spine, approach by removing bone. Patients undergoing this procedure sometimes experience more post-operative pain compared to those undergoing a procedure such as the ACDF mentioned above. Patients are often hospitalized from one to three days and, depending on the amount of pain, may require a minimal amount of assistance once they get home.