I've heard that surgery to fuse the spine done through the front of the neck can make patients lose their voices. Does it matter which side of the neck the surgeon operates on?

In the past, surgeons typically made incisions on the left side of the neck for this type of procedure. This was to avoid hurting the recurrent laryngeal nerve, or RLN. The nerve takes a more winding path on the right side of the neck, which was thought to put it at increased risk of injury during surgery on the right side of the neck. The RLN connects to the voice box (larynx). Injury to this nerve can cause hoarseness and even vocal cord paralysis.


However, research tells us that the risk of RLN injury is the same no matter which side of the neck is operated on. In a study of 328 patients, only nine (2.7 percent) had voice problems after surgery. The percentage of patients with injuries was 2.3 for those operated on from the right and 3.2 for those operated on from the left. In other words, the risk was basically the same for both sides. If this is your first surgery of this kind, the surgeon can operate on either side of your neck.


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