- Institute of Neuro Sciences
- Cervical Disease
What is cervical disease ?
Human body Comprises of six cervical discs and twenty three discs in the entire spinal column. Cervical spine is made up of seven bones called vertebrae. Each cervical disc acts as a shock absorber due to the lubricants like collagen and strings of bound ligaments plus water content present that bring in the flexibility and dexterity of the neck, shoulders and arms, without which the spinal cord would be a mere iron-rod.
Cervical disease is a pain in the neck. Many individuals, experience neck pain at some point of time. Cervical disc disease is a degenerative process which can cause radiating pain as well as numbness and weakness in shoulders arm and hand.
Symptoms of the disease :
The most common and underlying symptom of cervical degenerative disc disease is neck pain a stiff neck, headache, weakness of your shoulders, arms, hands, or legs and pain or numbness that travels down into shoulders or arms.
Severe back pain may generally last from a few days to few months before returning to the individual’s baseline level of chronic pain, which disturbs one’s normal activities including bending, lifting and twisting. Certain positions or postures may usually aggravate the pain.
Risk factors of the disease :
Degenerative disc disease is on account of wear and tear of the disc, as age advances or any strong injury to the spine or discs. Sometimes the disc protrudes out and touches the nerve routes causing immense radiating pain that may not be manageable. Degeneration happens gradually, but a slipped disc or herniated disc may irritate the nerve, and requires immediate attention like physiotherapy .
Diagnosis of cervical disc disease :
When in for a diagnosis the doctor checks medical history and analyses the pain intensity then decided upon diagnostic tests which may range between a simple X-ray to MRI. X-rays shows collapse or reduction in the height of disc and possible bone spurs and bony end plates changes.
The MRI shows if the disc is degenerated and best identifies the impingement on the nerves by bone or soft tissue surrounding them.
In patients with multiple degenerative discs and associated pain, it often difficult to distinguish which disc or discs are the pain generators. In such situations, additional more invasive types of testing may be required. They could include discography/CT a technique of injecting the discs with dye and taking a CT scan in which the patient identifies the quality and severity of the pain in each individual disc treated. These tests can help your doctor to point out the source of your neck pain.
Treatment of the disease :
The base line treatment for cervical degenerative disc disease is the same as for the degenerative disc disease in the lumbar spine. That is conservative care (non surgical) is recommended as the primary strategy like change in postures, basic exercises and physiotherapy. Surgery is considered as the final option.
Degenerative disc disease treatment can be approached without surgery. This is treated with pain medications, including acetaminophen , and nonsteroidal anti –inflammatory medications such as ibuprofen and naproxen as and when required only. These medications can help reduce pain and inflammation.
Physical therapy :
Physiotherapy is viable and affordable option. The therapist can gently manipulate the muscle and joints to reduce pain and stiffness. Physiotherapist shows some exercises and corrects the seating or standing postures to help reduce the neck pain. These basic initiatives do help pain management, surgery is considered if one is still not relived of the traumatic pain and has progressive neurological deficit.
If pain is not manageable and daily activities become difficult surgery may be considered.
The surgical procedure for degenerative disc disease is called discectomy. During this procedure the surgeon removes the deteriorating disc, after which a metal disc is inserted in place of disc that was removed. This is a type of treatment has been approved by FDA very recently. Discectomy may also be followed by cervical fusion. In this procedure a piece of bone is implanted in the space available between the vertebrae. In a traditional surgery the diseased disc is removed and the cervical vertebrae above and below the disc may be fused together.
Advantages of disc replacement surgery :
This surgery allows better movements and greater degree of flexibility and eases stress on the remaining vertebrae than traditional cervical disc surgery. This procedure is usually done under general anaesthesia. The actual procedure may take a few hours.
Risks of the procedure :
Disc replacement surgery though a safe procedure, may pose some risks such as leak in the spinal fluid, difficulty in swallowing or breathing or experiencing soreness which are usually associated with any other underlying health ailments or previous medical history of the person who has undergone the surgery.
What is the hospitalisation duration time ?
Normally hospitalisation time is 1 to 2 days. The patient may be kept under further observation if the pain persists or any other complications arise. The pain usually comes down in two to three weeks time.
Recovery and rehabilitation :
Recovery and rehabilitation may vary from case to case basis depending the factors of age, activity, mobility and intensity threshold.
Basic precautions one should take are to follow the doctor’s advice, and gradually take up movements as advised by the doctor. Diet and exercise regimen as scheduled by the doctors must be adhered to strictly. One should take enough rest as advised. The patient must consult the doctor if the patient experiences numbness, swelling or any other form of difficulty.
Once the condition improves, routine activities can be taken up including sports under the guidance and supervision of the doctors and therapists.