U2's Larry Mullen Jr Says Neck Injury Nearly Ended His Career: What Is a Congenital Facet Joint Fusion?

U2 drummer Larry Mullen Jr has opened up about a congenital neck problem that was aggravated by years of drumming and eventually became severe enough for doctors to advise him to retire.

Mullen Jr, 64, said he had known for years that he had a congenital fusion in a facet joint in his neck. However, he was able to continue performing until the demands of his career began making the problem increasingly difficult to manage.

Speaking to Rolling Stone, Mullen Jr said he was 'really in a bad way' by the 2019 leg of U2's Joshua Tree tour. He eventually underwent neck surgery, despite concerns from his family about the risks.

What Is a Facet Joint?

The cervical spine contains seven vertebrae, running from the base of the skull to the upper back. At the back of these vertebrae are small joints called facet joints, which help stabilise the spine while allowing the neck to bend, twist and move.

A congenital facet joint fusion means that part of the joint is abnormally fused from birth rather than developing as a normally mobile joint.

This is different from an acquired spinal fusion, which may be performed surgically or develop after certain injuries or diseases. It is also not automatically the same as Klippel-Feil syndrome, a rare congenital condition involving fusion of two or more cervical vertebrae.

How Could It Affect a Drummer?

A congenital fusion may not cause noticeable symptoms for years. Mullen Jr said he was able to 'get away with it for years' because the condition did not prevent him from performing.

However, drumming involves repeated, forceful movements of the upper body and neck. In his case, he said the demands of the job continually aggravated the underlying problem.

Facet joints are important for neck movement and stability, so changes affecting them can alter how forces are distributed through the cervical spine. Problems involving the joints can contribute to pain and restricted movement, although symptoms vary considerably between people.

By the end of the 2019 tour, Mullen Jr said the treatment he received each night to allow him to perform was making his condition worse. During the COVID-19 pandemic, he stopped playing drums because he was too sore.

Why Did He Need Surgery?

Neck surgery may be considered for some cervical spine conditions when symptoms are severe or persistent, although the approach depends on the underlying condition.

Treatment for cervical spine problems can include physiotherapy, medication, activity modification and injections, while surgery may be recommended in selected cases involving persistent symptoms, nerve compression, spinal cord problems or structural abnormalities.

Larry Mullen Jr has publicly opened up about his condition, revealing he suffered from a congenital fusion in a facet joint in his neck. Although he managed the condition for years, the physical demands of drumming gradually aggravated the problem, leaving him in severe pain by the end of U2's 2019 tour.

Doctors eventually advised him to retire, but Mullen Jr chose to undergo major neck surgery in the hope of returning to the band. He has said the procedure carried a risk of permanent paralysis, but he was willing to take that risk to play with U2 again.

He gradually returned to drumming after the surgery, although he remains uncertain whether his neck will allow him to perform an entire concert. Speaking to Rolling Stone, he said that even being able to play for an hour would be enough for him.