The term “neck surgery” is an umbrella phrase used by the public to describe a wide array of highly specialized medical procedures performed in the region between the base of the skull and the collarbones. This complex anatomical space contains the upper part of the spine, major blood vessels, nerves, the windpipe, and several important glands. A surgeon will use precise terminology to identify the exact structure being treated and the nature of the intervention. Understanding these specific names is the first step toward grasping the scope of a patient’s treatment.
Primary Classification of Neck Procedures
The technical name of a neck procedure is determined entirely by the underlying structure that is being addressed. This classification system organizes operations into three major domains: skeletal and neurological, glandular and soft tissue, and vascular and airway. Each domain involves different specialists, surgical approaches, and sets of risks. The skeletal and neurological category focuses on the cervical spine and the spinal cord.
The glandular and soft tissue domain involves endocrine organs and lymphatics, often addressing cancer or hormonal imbalances. The vascular and airway category includes surgeries on the carotid arteries, which supply blood to the brain, and the trachea or larynx, which govern breathing and speech.
Terminology for Cervical Spine Surgery
Procedures on the neck vertebrae, known as the cervical spine, are often referred to using acronyms that describe both the action and the anatomical approach. The most common is Anterior Cervical Discectomy and Fusion (ACDF), where the surgeon accesses the spine from the front of the neck. This procedure involves removing a damaged intervertebral disc and placing a bone graft or spacer to encourage the two adjacent vertebrae to fuse. The goal of the fusion is to stabilize the segment and relieve pressure on compressed nerves.
A similar anterior approach is used for Cervical Disc Arthroplasty (CDA), also known as Artificial Disc Replacement (ADR). Unlike ACDF, this procedure replaces the damaged disc with a prosthetic implant designed to preserve motion at that spinal segment. Preserving motion reduces the stress placed on adjacent discs. The choice between fusion and replacement depends on the patient’s age, spinal health, and the number of levels requiring intervention.
Other spinal procedures are performed using a posterior approach, with the incision made on the back of the neck. These decompression surgeries involve removing or reshaping bone to create more space for the spinal cord or nerve roots. A laminectomy, for example, is the removal of the entire bony arch (the lamina) that forms the roof of the spinal canal. This relieves pressure on the spinal cord caused by spinal stenosis or bone spurs.
A laminoplasty is a less invasive variation where the surgeon cuts the lamina on one side and hinges it open like a door. It is fixed in the open position with small plates to expand the canal without removing the bone entirely. For compression affecting a single nerve root, a foraminotomy is performed to enlarge the foramen, the small bony opening through which the nerve exits the spinal canal.
Procedures Involving Glands and Soft Tissue
Neck surgery frequently involves procedures on the endocrine glands, primarily the thyroid and parathyroid glands. A thyroidectomy refers to the surgical removal of all or part of the butterfly-shaped thyroid gland, which controls metabolism through hormone production. A total thyroidectomy removes the entire gland, necessitating lifelong thyroid hormone replacement therapy.
A partial thyroidectomy, or lobectomy, removes only one lobe of the gland, often allowing the remaining tissue to produce enough hormone to avoid replacement medication. This procedure is performed for conditions like large nodules, goiters, or localized thyroid cancer. Directly behind the thyroid are four smaller parathyroid glands; their removal is called a parathyroidectomy. This is done to treat hyperparathyroidism, a condition of overactive hormone secretion leading to high calcium levels.
The soft tissue of the neck contains a complex network of lymph nodes, which are often the target of a Neck Dissection. This procedure involves removing lymph nodes and surrounding tissue, primarily as a treatment for head and neck cancers that have spread. Depending on the cancer’s extent, the surgery may be a selective neck dissection, which preserves nerves and muscles, or a more extensive radical neck dissection. The goal is to remove all metastatic disease while minimizing functional and cosmetic impact.
Terminology for Vascular and Airway Surgery
The major blood vessels and breathing structures in the neck require specialized surgical interventions. One procedure is a Carotid Endarterectomy (CEA), a vascular surgery performed to clear a blockage from the carotid arteries, the vessels that carry blood to the brain. During this operation, the surgeon opens the artery and removes the atherosclerotic plaque (fatty buildup) from the inner lining of the vessel wall. Removing this plaque reduces the patient’s risk of suffering a stroke.
Airway procedures either create an opening for breathing or involve the removal of the voice box. A tracheostomy is the creation of a temporary or permanent opening (a stoma) into the trachea, or windpipe, through the front of the neck. This procedure is performed to bypass an upper airway obstruction or to provide a pathway for long-term mechanical ventilation.
In contrast, a laryngectomy is the surgical removal of the larynx (voice box), most commonly performed as a treatment for laryngeal cancer. A total laryngectomy removes the entire larynx, resulting in a permanent separation of the upper airway from the lungs. The patient breathes entirely through a permanent stoma in the neck. A partial laryngectomy removes only a section of the voice box, often preserving the patient’s ability to speak and maintaining a connection between the nose, mouth, and lungs.