Quick navigation links:

Understanding Your Cervical Spine | Your Nonsurgical Treatment Plan | Understanding Your Surgery | How Has Your Life Been Affected? | Consider Cervical Disk Surgery
______________________________________________________________________________

Neck

Understanding Your Cervical Spine

Your neck needs to be strong to hold up your head, which may weigh 10 pounds or more. But injury, poor posture, wear and tear, and diseases such as arthritis can damage the structures of your cervical spine. Or you may have a family tendency to develop disk problems. Pain and weakness in your neck and arms may result.

A Healthy Cervical Spine

The upper spine is a flexible column made up of the cervical vertebrae. These seven bones are separated by spongy, shock-absorbing disks. The spinal cord runs through a large central opening (spinal canal) formed by the vertebrae. Nerves branching from the spinal cord travel to your arms and other parts of your body through small openings (foramina) between the vertebrae. As you grow older, it's normal for your disks to wear out and harden. As a result, your neck may not be as flexible as it once was.

Your Problem Spine

One of the most common cervical spine problems is a damaged disk. A disk may be injured and bulge outward (herniation). The bulge may press on a nerve. Or it may wear out gradually (degeneration). A worn-out disk may become so flat that the vertebrae above and below it slip back and forth or almost touch. As disks wear out, abnormal bone growths (bone spurs) can form on the vertebrae and in the foramina, causing narrowing (stenosis).

With a herniated disk, the annulus tears or the nucleus pushes through the annulus. The herniated portion of the disk may press on a nearby nerve. This may cause neck or arm pain, or weakness in the arm.

In degenerative disk disease, the disks flatten over time. The surrounding vertebrae begin to touch, and the nerves may be pinched. Bone spurs may also form, further irritating the nerves.

In stenosis, bone spurs grow into the foramina and spinal canal, narrowing the openings. The nerves and spinal cord may be compressed, resulting in pain, weakness, numbness, and loss of coordination.

Arm pain and weakness may be caused by pressure on the nerves traveling from the cervical spine down the arm.
[Top]

Your Nonsurgical Treatment Plan

Your doctor may recommend rest, medications, physical therapy, exercises, or injections. These nonsurgical treatments often relieve symptoms. If your symptoms persist, you and your doctor may decide that surgery is the best option for you.

Relieving Your Symptoms

Your doctor may recommend:

• Medications to reduce the pain and inflammation in your neck. Take medications on time, as directed.

• Epidural steroid injections (injections into the spinal canal near the spinal cord). This may relieve severe pain and reduce inflammation.

• Restricted activities or bed rest to give your cervical spine a chance to heal.

• A soft cervical collar to wear for a couple of weeks. The collar helps support your head while keeping your cervical spine aligned.

• Traction two or more times a day for a couple of weeks. This may help relieve the pressure on the irritated nerves in your cervical spine.

Restoring Movement and Strength

To help you regain strength and movement in your neck, your doctor may prescribe physical therapy. A physical therapist may teach you special exercises to improve your neck's strength and range of motion. Posture and movements that can affect your cervical spine may be evaluated and corrected. Therapies such as heat, massage, and traction may also help to relieve your symptoms.

Self-Care

You'll take an active role in your therapy. To protect your neck from further injury:

• Follow any exercise program given to you by your doctor or physical therapist. This may include resistance and range-of-motion exercises.

• Practice good posture whether you're sitting, standing, or moving.

• Have your workspace evaluated. Rearrange it as suggested. Using a telephone headset even at home may help you avoid painful positions.

• When lying on your back, support your neck with a special cervical pillow or a rolled-up towel.

Resistance exercises can help strengthen your neck muscles. Place your hand on one side of your head. Press your head against your hand, and push back (resist) with your hand. Repeat on the other side.

Range-of-motion exercises can reduce neck stiffness and increase flexibility. Slowly bend your neck to one side, then return it slowly to the center. Repeat on the other side.
[Top]

Understanding Your Surgery

During surgery, your surgeon may remove all or part of the disk (diskectomy). To reach the cervical spine, he or she may make an incision in the front (anterior) or the back (posterior) of your neck. With the anterior approach, the neck may be made more stable with a fusion (joining) of the vertebrae. With the posterior approach, bone may be removed to enable your surgeon to reach the disk.

Through the Front: Anterior Approach

Your surgeon will make a horizontal or vertical incision (about 1 to 3 inches long) on either side of your neck. To reach the disk, soft tissue is moved aside. All or part of the disk that is irritating the nerve is then removed. Your surgeon may remove bone spurs. The vertebrae may then be prepared for a fusion.

Adding Stability: Fusion

After removing a disk from the front, your surgeon may fuse the vertebrae above and below it. This limits movement, helping to relieve pressure and pain. First, the surgeon enlarges the space between the vertebrae. The surgeon then "plugs" the space with a cylinder- or wedge-shaped bone graft. Metal plates may be added. As you heal, the graft and vertebrae grow together. After fusion, your ability to bend your neck may be slightly restricted.

The disk is removed from between the vertebrae.

A bone graft is inserted to plug the opening.

A metal plate may be used to keep the vertebrae stable.

Through the Back: Posterior Approach

Your surgeon will make an incision (about 2 to 4 inches long) in the middle of the back of your neck. Then he or she may remove bone to reach the problem area. The surgeon then removes the damaged portion of the disk.

Removing Bone

To reach the disk from the back, your surgeon may enlarge the foramina or remove a portion of the lamina. To help relieve pressure on the nerves or spinal cord, bone spurs may also be removed.
[Top]

How Has Your Life Been Affected?

Take a look at how your cervical spine problem has affected your life by answering the following questions. This self-assessment may help you decide if the benefits of treating your neck problem outweigh the risks and inconvenience of surgery.

Physical Effects

• Do you miss work because of your pain?

• Does your neck pain shoot down your arm?

• Does your arm or hand feel numb or weak?

• Do you have headaches, or pain between your shoulder blades?

Social Effects

• Are you unable to join in family activities because of your pain?

• Does your pain force you to spend time alone, away from family and friends?

• When you are with other people, do you find yourself distracted by your discomfort and unable to enjoy yourself?

Emotional Effects

• Does your pain make you feel frustrated or depressed?

• Are you afraid of losing your job due to too much time off?

• Do you ever feel that other people think your pain isn't real?

• Do you feel that you have no control over your life?
  [Top]

Consider Cervical Disk Surgery

Do you suffer from nagging neck and arm pain or weakness caused by a disk problem in your upper (cervical) spine? Is a simple turn of your head painful or even impossible? If nonsurgical care hasn't helped you, your surgeon may suggest cervical disk surgery.

When Pain Takes Over Your Life

Any pain can be annoying. But ongoing pain or weakness in your neck or arm can restrict the use of your arm and hand. This can impair your ability to work. Even worse, you may have found that none of the treatments you've tried?rest, medication, physical therapy, injections?have relieved your symptoms. You may feel as though pain has taken over your life.

Cervical Disk Surgery May Help

Most cervical disk problems improve with nonsurgical care. But many people find relief from pain and weakness only after cervical disk surgery. During this surgery, your surgeon may be able to treat the problem causing your symptoms. Surgery has its limitations?it can't remove all the effects of overuse or aging, and it does have risks. Yet, it may let you take control of your life again.
[Top]

This content is not intended as a substitute for professional medical care. Only your doctor can diagnose and treat a medical problem. © 1990, 1995, 1998, 2000 The StayWell Company, 1100 Grundy Lane, San Bruno, CA 94066-3030. www.krames.com 800-333-3032. All right

NO PHYSICIAN REFERRAL IS NEEDED UNLESS REQUIRED BY YOUR INSURANCE

Quick navigation links:

About Us | Treatment | Conditions | Educational Resources | Contact Us | Site Map

Educational illustrations and content Copyright © 2009 Prizm Development, Inc.
Web design & Copyright 2009 © Prizm Development, Inc.
www.prizmdevelopment.com