Surgery is rarely the first option - but in some cases, it’s the right one.
At The Pain Collective, we are committed to treating neck pain conservatively and comprehensively. However, when non surgical treatment is no longer enough, we’re here to guide you through your surgical options - with care, clarity, and clinical precision.
Our Approach: Non-Surgical First
Most cases of neck pain do not require surgery. In fact, the majority of patients improve significantly with a multi-modal, non-invasive approach that combines interventional pain procedures, physiotherapy, posture correction, and lifestyle changes.
But when symptoms progress, neurological function is threatened, or the underlying condition is too advanced for conservative care alone, surgery may be the next step. We approach surgical referral cautiously and collaboratively — always in your best interest.
When Might Surgery Be Needed?
The decision to consider surgery is not based on pain severity alone. Instead, surgery is typically considered when:
There is structural compression of the spinal cord or nerve roots (e.g. from a herniated disc or bone spur).
There is progressive neurological dysfunction, such as:
Arm weakness or numbness.
Loss of fine motor control.
Coordination issues or walking instability.
Bladder or bowel dysfunction.
There is spinal instability, deformity, or fracture.
Non-surgical treatments have failed after a reasonable trial.
Surgery is never a first-line solution for pain alone. We only consider surgical referral when your condition is unlikely to resolve without it — and when we believe surgery offers real, lasting benefit.
Common Surgical Procedures for Neck Pain
While each patient’s situation is unique, these are the most common surgeries you may hear about:
Anterior Cervical Discectomy (with or without Fusion)
Removes a damaged or herniated disc from the front of the neck, relieving nerve compression. Fusion may be added to stabilise the spine.
Cervical Disc Arthroplasty (Disc Replacement)
Replaces the damaged disc with an artificial one, preserving motion. This is suitable for select patients and requires surgical expertise.
Cervical Laminoplasty / Laminectomy
Removes or reshapes part of the vertebra to enlarge the spinal canal and relieve pressure on nerves. Often used for spinal stenosis.
Posterior Cervical Fusion
Used when instability or deformity is present. Involves joining vertebrae at the back of the neck with hardware for stability.
Cervical Foraminotomy
Enlarges the passageway where nerves exit the spine (foramina) to relieve compression and restore function.
We do not promote surgery. Our role is to educate and guide - ensuring you are informed, prepared, and confident in your decision.
What Happens if You Need Surgery?
At The Pain Collective, you are not alone in this process. If surgery becomes necessary:
- We refer you to a qualified, experienced spinal surgeon best suited to your condition.
- We share your clinical notes, imaging, and response to prior treatment with the surgical team.
- We help you understand the risks, benefits, and alternatives so that you can make informed decisions.
- If surgery is completed, we coordinate with your surgeon for pre-operative preparation and post-operative rehabilitation.
Rehabilitation and Recovery
Surgery often addresses structural problems, but it’s rarely the final step in your care. Our team will continue to support you after surgery with:
- Physiotherapy and movement rehabilitation.
- Pain management and healing strategies.
- Lifestyle and ergonomic coaching.
- Long-term management of underlying spinal conditions.
We believe in lifelong support, even when the surgical phase is complete. You remain part of our care network.
Have Questions About Surgery?
It’s normal to feel uncertain, overwhelmed, or anxious. Perhaps someone you trust has recommended surgery. Maybe you’ve already consulted a surgeon. Or maybe you're still unsure whether surgery is even necessary.
Wherever you are in your journey, we’re here to help you find clarity. We will assess your condition, review your treatment history, and offer an honest, evidence-based opinion on what to do next.
Dr Willem Adriaan Liebenberg, MBChB, MMed (Neurosurgery), FCS (Neurosurg) SA. Dr Liebenberg is a neurosurgeon and founder of The Pain Collective, a national network of interdisciplinary pain clinics across South Africa. With over 20 years of clinical experience, he specialises in minimally invasive spine care and holistic chronic pain management. He is also Director of The Health Collective and a Council Member of PainSA.