Neck pain after styloidectomy, positioning during surgery

Hope that sharing my experience might help someone else. Immediately after surgery I was surprised by terrible neck pain on the other side from the styloidectomy. At home a week later it was even worse. I knew I have cervical spine degeneration, but until then it was not a bad pain problem.

I had asked the anesthesiologist to use a flexible esophageal tube. She said it was not possible due to the nerve monitoring. They use something like tiny clips on the nerves.

Around a month after the surgery I finally saw a neurosurgeon. This required a referral and a recent MRI. He thought the pain was probably triggered by the positioning during surgery. He prescribed a week of prednisone, tapering. By the third day the pain was better. A week later, however, it was still a problem.

Last week I saw a nurse practitioner who used to work in Anesthesiology. He demonstrated the probable position of the neck during the surgery. It was scary, bent back tremendously.

I hope to get some kind of cortisone injection before the next styloidectomy.

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So sorry that you’re having so much pain, I hope that a cortisone injection does help…I know the head has to be tilted right back for intubation. Other members have had jaw problems after surgery too, I guess that there’s not to much can be done, although worth discussing with an anesthesiologist beforehand…

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Thank you for that info. I’m so sorry… another problem is all any of us need. Could you share who your doctor was?

Simply it’s that I should have taken care of my common cervical spine problem before the specialized surgery. I’m grateful to the surgeon!

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@Leah - Dr. Hepworth did violin’s surgery. Neck/tmj pain post op pain is not uncommon because of the head position/neck positioning during surgery. Once the body is totally relaxed by anesthesia some doctors actually dislocate the jaw to make the styloid more accessible. This often isn’t discussed prior to surgery & it can cause those w/ prior tmjd issues to have extra jaw joint pain post op. It’s definitely a topic worth discussing w/ any surgeon you see.

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Thank you @Isaiah_40_31. Very important info since many have cervical spine issues already. I have suspected I had worse issues after my C6/C7 fusion… possibly stretching muscles that had trigger points that didn’t want to stretch …

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This morning pain at my lower left neck is bad.

And I’m almost happy! With the complex nature of venous Eagles where I had occipital pain on left, I was in misery.

This morning I can tell that the source is the lower left spine (C6-7, like you Leah?).

Let’s hope this means that the surgery has mitigated part of my left side of neck pain, the occipital part.

It has been so frustrating, and I’ve had to endure humiliation by healthcare professionals, when the pain has been so complex. They were frustrated too, because I couldn’t articulate better for them to help me.

Add memory challenges….


I’m so sorry for your neck pain today. You could try icing your lower neck in the back to see if that helps. Heat would be the next line of defense if ice doesn’t work. Glad that the skull base pain has subsided on the left!

Our necks are so complicated as you noted because of the many nerves & vascular tissues that are threaded into a small space. It is hard to know what’s causing which problems. I hope your pain resolved soon.

Sending you a healing hug.


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Hope the pain settles soon, hugs & prayers :hugs: :pray:

@Violin I too have endured ridiculous amounts of, maybe the best I can say, is “lack of care“ from the medical professions. And I’m so sorry you have as well; seems this is the common experience with having rare conditions.

What I might would try is as @Isaiah said, ice for sure… Lidocaine patch if you have or can get. Gabapentin if you still have problems…and using these with the hope that you’ve got inflammation and not a bulging disc or other.

Hoping you find relief )).


Thanks. Yes lidocaine 5% patches help. I’m scheduled now for steroid injections in a month or so. Any downside to doing this?


The injections don’t help everyone, they can be done guided by ultrasound which is the safest way to do them.

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My first steroid injections were years ago… And I didn’t really receive much benefit.

I don’t know if they can do ablation there, that may be what would give you relief. It may be as well that they have to go through the insurance procedures, which may mean steroid injection first, then nerve blocks, then RFA, which would give up to a year and a half or so relief.

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My mother hd RFA for a compression vertebral fracture. It gave her relief for about 2 weeks.

Well, that stinks! Friend of mine had it done for upper to mid levels maybe C3 through C5 and lasted about six months… It’s been on my radar, so sorry that your mother did not get relief.

That was abt 10 yrs ago so maybe the technique has improved.

Yes, I think the dr said it was diagnostic as well as hopefully beneficial.

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More information

Spinal neurosurgeon found that my C2-3 have naturally fused. What has caused this? What does it mean?

After styloidectomy jugular decompression with Dr Hepworth, first one of two, the other side neck pain was very bad, presumably combination of anesthesia positioning and underlying cervical spine problems. So I’m following up to treat the cervical spine issues. This natural fusion is a surprise.

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That’s really unusual, did you get an chance to speak to the spinal neurosurgeon to ask about it, I’m guessing not? So frustrating that after surgery you’re uncovering more issues :hugs:

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There are a couple of other problems, we talked mainly about them, and how there’s more stress above and below C2-3 due to the fusion. I’ll look into it further.

But mainly I’m happy to be heading back to Denver in a couple of weeks to get the second styloidectomy jugular decompression. Dr H. will also do something to improve the vocal chord dysphasia that occurred during the last surgery, which has made my voice strangely soprano.

Thank you for your support!