Degenerative Discs of the Neck
When the discs between the vertebrae in your cervical spine (neck) dry out, they can push against your nerves and cause severe pain.
The discs that sit between the seven vertebrae in your lumbar spine allow your neck to be flexible. These discs are made up of two types of cartilage: a tough outer part, and a more “jelly-like” inner part. This inner cartilage acts as a shock absorber.
Normal discs absorb water so they can stay hydrated. Over time, though, discus can become dried out (dessicated) and act like flat tires. If this flattened disc material pushes against your nerves, you can experience severe pain down your armss, known as radiculopathy. Patients will often describe the onset of these symptoms after they were lifting something, bending, and/or twisting their necks.
Signs and symptoms
In addition to neck pain, pressure on nerves from a degenerative disc can also cause numbness, tingling, burning, and weakness in your arm. Bone spurs and degenerative discs can compress your spinal cord leading to balance difficulties, problems using your hands, and even paralysis of your arms and legs. This is called myelopathy, and can be considered a medical emergency. If you experience bowel or bladder problems and have progressively worsening weakness in your arms or legs, you should seek medical attention immediately.
Diagnosis
Orthopedists may first suspect the diagnosis when a patient complains of pain radiating from the neck down the arm. Patients will also commonly complain of numbness, tingling and burning down their arm. They may also have muscle
weakness.
After a detailed examination, the physician will evaluate the initial diagnosis with plain X-rays and can confirm it with an MRI or CT of the cervical spine.
Treatment
Luckily, most degenerative discs do not require surgery because it is a natural result of time. Therefore, many patients can initially be treated with pain management, physical therapy, and activity modification.
For patients with more severe or persistent symptoms, they may benefit from anepidural spinal injection. Patients with very severe pain and those who do not achieve long lasting pain relief from injections, may be candidates for surgery. One of the most common surgical procedures we use to remove the herniated disc is called a minimally invasive decompression (laminoforaminotomy) and is performed through a half-inch incision through the back of the neck. Patients are able to go home the same day as the procedure.
The other time-tested surgical approaches involve going through the front of the neck and include either fusing the vertebrae or replacing the disc with an artificial prosthesis. Your surgeon can go over the advantages and disadvantages of each of these surgical options with you.
