Cervical Disk Disease

Definition

Cervical disk disease refers to a gradual deterioration of the spongy disks in the top part of the spine.

Description

The spine is made up of 33 bones called vertebrae separated by spongy rings of elastic material. These rings, known as disks, are often compared to shock absorbers because they help to cushion the vertebrae. Just as importantly, they also make it possible to turn the head and neck. Over time, these disks slowly become flattened and less elastic due to everyday wear and tear. When this process occurs in the disks of the neck, it is referred to as cervical disk disease. Other general terms for this process include degenerative disk disease and intervertebral disk disease.

Cervical disk disease affects everyone to some degree, often without causing any bothersome symptoms. However, this condition can also lead to specific problems related to nerve functioning. For example, the outer edge of a disk may tear, allowing the gelatinous material inside to bulge outward (herniated disk ). This can put pressure on nerves that exit the spine. Two adjacent vertebrae may rub together (sometimes resulting in bone spurs) that can also pinch these nerves. In other cases, the inner part of the ring may push on the spinal cord itself, which passes through the disk. Any of these situations can cause pain and limit movement. While symptoms primarily affect the neck, they can also occur in other parts of the body.

Causes and symptoms

Cervical disk disease is a gradual process that occurs with aging, though poor posture, repeated lifting, and tobacco use can hasten its course. Symptoms include pain when moving the neck and limited neck movement. The condition can also affect the hand, shoulder, and arm resulting in pain, numbness/tingling, and weakness. If the spinal cord itself is affected, these symptoms may occur in the legs. Loss of bowel or bladder control may also occur.

Diagnosis

Cervical disk disease is typically diagnosed by an orthopedist or a neurologist. After taking a medical history and conducting a physical examination, the doctor will recommend an imaging procedure to gather more information about the nature of the problem. This may include a CT scan, an MRI, or myelography. In addition, an electromyogram (EMG) may be used to evaluate the functioning of nerves in the arms, hands, or legs. Cervical disk disease is typically covered by medical insurance.

Treatment

Treatment usually involves physical therapy, several weeks of drug therapy with nonsteroidal anti-inflammatory drugs (NSAIDs), and limited use of a cervical collar (to reduce neck movement). Neck traction and heat treatments may also be recommended. In some cases, steroids or anesthetic drugs may be injected into the spinal canal to help alleviate symptoms. Aside from these measures, maintaining good posture and placing a pillow under the neck and head during sleep can be helpful. Treatment may last anywhere from several weeks to three months or more. Neck surgery is not usually advised unless other therapies have failed.

Alternative treatment

Acupuncture, therapeutic massage, and yoga are believed by some practitioners of alternative medicine to have generalized pain-relieving effects. However, any therapy that involves manipulating the neck is not recommended and be approved by primary doctor beforehand.

Prognosis

In most people symptoms go away within three months if not sooner. A smaller number may require surgery to correct the problem.

Prevention

While some degree of disk degeneration is inevitable, people can reduce their risk by practicing good posture (during sitting, standing, and lifting), performing neck-stretching exercises, maintaining an ideal weight, and quitting smoking.

Resources

PERIODICALS

Heckmann, J. G., et al. "Herniated Cervical Intervertebral Discs with Radiculopathy: An Outcome Study of Conservatively or Surgically Treated Patients." Journal of Spinal Disorders 12 (October 1999): 396-401.

ORGANIZATIONS

American Academy of Orthopaedic Surgeons. 6300 North River Road, Rosemont, IL 60018-4262. (800) 346-2267. 〈http://www.aaos.org〉.

KEY TERMS

Bone spur— An overgrowth of bone.

Cervical— Relating to the top part of the spine that is composed of the seven vertebrae of the neck and the disks that separate them.

Computed tomography (CT) scan— An imaging procedure that produces a three-dimensional picture of organs or structures inside the body.

Myelography— An imaging procedure involving the injection of a radioactive dye into the fluid surrounding the spine. A myelography can be used to detect herniated disks, nerve root damage, and other problems affecting the cervical spine.

Neurologist— A doctor who specializes in disorders of the brain and central nervous system.

Orthopedist— A doctor who specializes in disorders of the musculoskeletal system.

Magnetic resonance imaging— A type of imaging that uses magnetic fields to generate a picture of internal structures.