“Never put off until tomorrow what you can do the day after tomorrow.” – Mark Twain
I often get asked by my patients, “At what point will I NEED surgery?”
In the setting of weakness or numbness, cervical surgery may be offered sooner than later. This is also true if there is compression of the spinal cord.
But in the setting of just pain, many surgeons often preach to hold off on cervical surgery until the patient can no longer take it anymore. This conservative approach in many situations is very reasonable since surgery can be very invasive.
A recent 2019 study, however, compared patients undergoing neck fusion who had pain for less than 6 months to patients with longer-lasting symptoms. Pain for more than 2 years predicted significantly worse outcomes, including worse quality of life. If symptoms were present for less than 6 months, patients demonstrated less disability, neck pain and arm pain following surgery. For the procrastinator needing neck surgery… tomorrow may be too late.
Tarazona D et al. Longer preoperative duration of symptoms negatively affects health-
related quality of life after surgery for cervical radiculopathy. Spine. 44(10), 2019.