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Cervical (Neck) Degenerative Conditions

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The neck is also susceptible to osteoarthritis and degenerative disc disease, which can be caused by general wear and tear on the spine. The discs begin to lose their flexibility and ability to absorb stresses in the spine. Or, bone spurs develop on the vertebrae. In either case, the nerves in the cervical spine can become irritated or pinched, causing pain in the neck or the arms. If there is a great deal of degeneration in the cervical spine, the spinal cord and nerve roots may become compressed, causing irreversible damage.

Cervical stenosis is another condition that may result from degeneration in the spine. It occurs when the spinal canal narrows and compresses the spinal cord. If the pain from stenosis is restricted to the neck, conservative treatment is prescribed. However, if it extends into the arms or legs neurosurgeons can remove part of the vertebrae and ligaments to allow more room for the spinal cord and nerves. If there is significant degeneration in the cervical spine, the neurosurgeon can fuse the vertebrae by grafting bone or using metal plates to provide additional support and stability in the spine.

"The cervical spine is a delicate area and the surgeon must use an exact touch," said Edward C. Benzel, MD. "The brain and the cervical spine are the two areas of the body where there is little margin for inaccuracy and the neurosurgeon's hands and instruments must be precise and controlled. I like to compare it to a jump shot that hits 'nothing but net.'"

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Updated on: 01/12/10
Stephen E. Heim, MD
As described by Drs. Sonntag and Benzel, there are a wide variety of causes of neck pain and associated nerve root, or spinal cord compression symptoms. Scenarios including significant spinal instability (such as fractures, or ligamentous injuries to the spine), or those involving significant nerve/spinal cord compression, may require early surgical intervention. The larger percentage of patients with neck pain and/or associated nerve root compression can be treated successfully by non-surgical means. Many times an initial consult with a spine surgeon (Orthopaedic/Neurosurgeon/or fellowship trained subspecialist) is appropriate to determine whether or not a given patient is appropriate to attempt non-surgical management. As mentioned by Dr. Benzel, if an initial course of well orchestrated physical therapy (usually 4 to 8 weeks) is unsuccessful, surgical intervention may then be an alternative. Whether surgical or nonsurgical treatment is utilized, the patient will often times be prescribed an ongoing (and relatively simple) exercise regimen. The continuation of such an exercise program can many times be of significant benefit in avoiding varying degrees of stiffness or achiness, which may be experienced following a neck injury or surgery.
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