What diseases and disorders affect your cervical spine?
Many diseases and conditions result from problems in the cervical spine and the surrounding soft tissues and nerves. These include:
- Cervical radiculopathy. This condition arises when a cervical nerve is pinched by cervical vertebrae. You may experience tingling, numbness, weakness and pain. Symptoms may remain local or can spread to your entire arm, hand and fingers. Cervical radiculopathy is also called a pinched nerve or cervical nerve compression.
- Neck pain. Neck pain is a common symptom of many different injuries and medical conditions. Common causes include degenerative conditions (osteoarthritis, spinal stenosis, herniated disk, pinched nerve), whiplash, mental stress, physical strain, poor posture, growths (tumors, cysts, bone spurs), meningitis, rheumatoid arthritis and cancer.
- Cervical degenerative disk disease. Cervical degenerative disk disease occurs when the disks in your cervical spine wear down.
- Herniated disk. This condition is a tear or leak to the disks that provide a cushion between vertebrae. Intervertebral disks allow you to bend and move with ease.
- Bone spurs in your cervical spine (cervical osteophytes). Bone spurs are growths that occur on any of the seven vertebrae in your cervical spine.
- Cervical spondylosis. Cervical spondylosis, also called arthritis of the neck, is the age-related slow degeneration of your disks and joints in your cervical spine
- Cervical spinal cord injury. A cervical spinal cord injury is an injury to your cervical vertebrae. Most spinal cord injuries are the result of a sudden, traumatic blow to the vertebrae.
- Cervical spinal fracture. A fracture to the bones of your spine can result from compression (often from minor trauma in a person with osteoporosis) or be a burst fracture (vertebra that’s crushed in all directions) or a fracture-dislocation (mostly from vehicle accidents or falls from heights).
- Cervical spinal cord compression (cervical spondylotic myelopathy). This is a condition in which there’s pressure on your spinal cord in the cervical area of your spine. One of the most common causes is wear and tear on the bones of your spine, a condition called osteoarthritis.
- Cervical stenosis. This condition occurs when your spinal canal in the cervical spine area narrows. Less space within your cervical spine reduces the amount of space available for your spinal cord and nerves that branch off the spinal cord. A tightened space can cause your spinal cord or nerves to become irritated, compressed or pinched.
- Cervical spinal tumor and cancer. Tumors are abnormal growths of tissue inside your spinal column. They can either be noncancerous (benign) or cancerous (malignant).
- Meningitis. Meningitis is an infection of the meninges. The meninges are a protective lining around your brain and spinal cord.
- Osteomyelitis. Osteomyelitis is a bacterial or fungal infection of the bone, in this case, the vertebrae of your spine. If left untreated, it can lead to the death of vertebrae.
How are diseases and conditions of the cervical spine diagnosed?
First, your healthcare provider will gather your medical and medication history, ask you about your symptoms, perform a physical exam and order tests and imaging studies.
Tests and imaging may include:
- Computed tomography (CT) scan. This scan uses X-rays and computers to produce images that are very thin “slices” of the area under examination. A CT scan can show the shape and size of your spinal canal, its contents and the bone around it. It helps diagnose bone spurs, osteophytes, bone fusion and bone destruction from infection or tumor.
- Magnetic resonance imaging (MRI). This test uses a large magnet, radio waves and a computer to produce detailed images. This scan can reveal problems with your spinal cord and nerves exiting the spinal column, spinal degeneration, disk herniation, infections and tumors.
- X-rays. X-rays create pictures of your bones and soft tissues, using a small amount of radiation. X-rays can show fractures, disk problems, spinal alignment problems and the presence of arthritis.
- Electromyogram (EMG) and nerve conduction studies. An EMG helps evaluate the health and function of nerves and muscles. A nerve conduction study measures how fast an electrical impulse moves through your nerve. These tests help determine ongoing nerve damage and the site of nerve compression.
- Myelogram. This imaging test examines the relationship between your vertebrae and disks, outlines the spinal cord and nerves exiting your spinal column. It shows if such possible things as a tumor, bone spurs or herniated disk are pressing against your spinal cord, nerves or nerve roots and causing pain, numbness or weakness.
- X-rays. X-rays create pictures of your bones and soft tissues, using a small amount of radiation. X-rays can show fractures, disk problems, spinal alignment problems and the presence of arthritis.
How are cervical spine health issues treated?
Both nonsurgical treatment options and surgery are available to treat many of the conditions that affect the cervical spine. The choice depends on the cause of the cervical spine issue and its severity.
What are the nonsurgical treatment options for cervical spine conditions?
Your healthcare provider may first recommend less invasive approaches for neck pain that aren’t caused by trauma or a tumor. Some common nonsurgical treatment options include:
- Rest.
- Ice or heat.
- A soft cervical collar. A collar helps support and immobilize your neck.
- Avoiding strenuous or aggravating physical activity.
- Physical therapy.
- Medications, including muscle relaxants, pain relievers (such as acetaminophen) and anti-inflammatories (such as ibuprofen and naproxen).
- Steroid injections. Two specific types of steroid injections may be considered for neck and/or arm pain. A cervical epidural block is a procedure in which the steroid is injected into the epidural space (the space next to the covering of youe spinal cord). Cervical facet joint block is a procedure in which the steroid is injected into the capsule (connective tissue covering) of the facet joint (the small joint at the top and bottom of each vertebra that connects the vertebrae to permit motion).
- Medical branch block and radiofrequency ablation. This procedure is considered in some cases of chronic neck pain. First, a local anesthetic is injected into the nerve that supplies the facet joint of the vertebrae. If your pain is relieved, the next step is to make pain relief permanent. This is done by damaging your nerve with a technique called radiofrequency ablation. Pain relief lasts for months. If your nerve regenerates, the pain can return.
How do I know if I’m a candidate for cervical spine surgery?
You may be a candidate for cervical spine surgery if:
- Other treatments aren’t helping.
- Symptoms involving your spine, arms and/or legs are worsening.
- You’re healthy enough to have surgery.
What surgical treatment options are available for cervical spine conditions?
Common surgical approaches include:
Cervical spinal decompression surgery
Cervical spinal decompression surgery is a general term that refers to various procedures used to relieve symptoms caused by pressure, or compression, on your spinal cord or nerve roots. Nerve roots are the first segment of a nerve that leaves your spinal cord through the small hollows between the vertebrae. Common surgical techniques for decompression include:
- Cervical diskectomy. In this procedure, your surgeon removes a portion of a disk to relieve pressure on the nearby nerve roots.
- Cervical laminotomy or laminectomy. In these procedures, your surgeon removes a small part of the bony arches of the spinal canal, called the lamina. Only a small section of the lamina is removed in a laminotomy. The entire lamina is removed in a laminectomy along with any bone spurs, disk material and thickened ligament if needed. Removing the lamina increases the size of the spinal canal, which relieves pressure.
- Cervical foraminotomy or foraminectomy. Both of these procedures are performed to expand the openings for the nerve roots to exit your spinal cord by removing some bone in that area. In a foraminectomy, a large amount of bone is removed.
- Cervical corpectomy. In this surgery, your surgeon removes the body of the vertebra (the large front portion of the vertebra), as well as the disk to relieve pressure on the spinal cord. In some cases, this is followed by fusion of the vertebrae (permanently connecting two or more vertebrae) to keep your cervical spine stable.
Cervical disk replacement surgery
Cervical disk replacement surgery involves removing a diseased cervical disk and replacing it with an artificial disk. The most common reason for this procedure is cervical disk degeneration.
Cervical spinal fusion
Cervical spinal fusion is surgery that permanently connects to one or more cervical vertebrae. The surgery eliminates the motion between vertebrae.
Functional electrical stimulation for spinal cord injury
Functional electrical stimulation for spinal cord injury. This procedure uses small electrical impulses to activate specific muscles and nerves to restore function to your upper body muscles controlled by cervical nerves.
Is having minimally invasive cervical spine surgery a possibility?
Speak with your surgeon. In many cases, minimally invasive spine surgery is an option. Compared to the one large incision through your skin with traditional open surgery, minimally invasive surgery is performed through one or more smaller incisions. Working through smaller incisions causes much less damage to muscles and soft tissues than a single long incision.
A note from Cleveland Clinic
Your cervical spine is the neck region of your spinal column or backbone. It consists of your first seven bones (C1-C7). Other structures in or around your cervical spine are your intervertebral disks, spinal cord and nerves, muscles, tendons and ligaments. Your cervical spine supports the weight of your head and allows a wide range of head movement. Its circular surround of bone also protects your spinal cord. Many diseases and disorders can affect your cervical spine. Fortunately, many nonsurgical and surgical options can treat these conditions.