Cervical Degenerative Disc Disease
Cervical Anatomy
The intervertebral disc is composed of an inflexible ring called the annulus fibrosis which encloses a gelatinous inner structure called the nucleus pulposus. The discs are kept in position with the help of endplates between two vertebral bodies. The intervertebral discs act as shock absorbers.
What is Cervical Degeneration Disorder?
Cervical degenerative disc disease (DDD) is a misnomer as it is not a disease but a condition that affects the strength, resiliency and structural integrity of the intervertebral discs due to increasing age, trauma, injury, repetitive movement, improper posture, or poor body mechanics. Cervical DDD is commonly seen in adults after 50 years of age and most of them are usually not aware of their condition until they are examined for some other health condition.
Causes of Cervical Degeneration Disorder
As we age, the rate at which the old, worn-out cells are replaced is gradually reduced, resulting in the degenerative changes in the discs, which can also be accelerated by injury or trauma.
Impact of Cervical Degeneration Disorder
These structural changes can cause a sequence of other changes, resulting in nerve compression and pain due to a reduction in the disc height, and the presence of bone spurs or bony overgrowths (osteophytes). Other conditions such as cervical spinal stenosis and osteoarthritis (spondylosis) can also affect the intervertebral joints and cervical stability.
Symptoms of Cervical Degeneration Disorder
Cervical DDD is mostly asymptomatic; however, it may be associated with a gradual development of symptoms that may further deteriorate with time. You may experience pain and other symptoms in their shoulder and arms, this is known as radiculopathy. Some of the other common symptoms of cervical DDD include:
- Mild to intense pain
- Increased pain with movement
- Burning, tingling or numbness
- Stiffness in hand or arm
- Improper balance and gait
- In rare cases, bowel and bladder dysfunction
Diagnosis of Cervical Degeneration Disorder
Seek a specialist’s advice for your neck pain and pre-existing or changing spinal disorder as an accurate diagnosis is crucial for effective and successful treatment.
An accurate diagnosis of cervical DDD comprises of:
- Your medical and family history
- Physical and neurological examinations
- Testing of reflexes to evaluate muscle weakness, sensitivity and other signs of neurological injury
- Diagnostic imaging techniques such as X-rays, CT scan, MRI scans, discography or fluoroscopy, to confirm the diagnosis
Simple X-rays help in the identification of the collapsed disc space. X-ray images of the spine, at different positions, also helps evaluate the stability of the spine. CT and MRI scans are more precise in evaluating the disc and endplate changes. In discography, a special dye is injected into one or more discs to identify the damage such as a crack or tear. Real-time X-ray (fluoroscopy) helps to locate the origin of pain.
Treatment of Cervical Degeneration Disorder
Both surgical and non-surgical methods can be used in the treatment of cervical DDD. The initial approach comprises of non-surgical options, and sometimes a combination of two or more therapies may be used to relieve pain and other symptoms. The non-surgical options include:
- Medications such as analgesics, muscle relaxants, and narcotics
- Spinal injections
- Supporting the spine with braces to relieve pain
- Physiotherapy
- Acupuncture
Surgical treatment is recommended if you have failed to respond to non-surgical treatments or have spinal instability and neurological dysfunction. In such cases, minimally invasive spine surgery can be performed. Spinal stabilization and fusion can be considered in a few cases to prevent further deterioration of your condition.
