Cervical spine disorder

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Cervical spine disorder
Cervical vertebrae - close-up - animation2.gif
Cervical vertebrate

Cervical spine disorders are illnesses that affect the cervical spine, which is made up of the upper first seven vertebrae, encasing and shielding the spinal cord. This fragment of the spine starts from the region above the shoulder blades and ends by supporting and connecting the skull. [1]

Contents

The cervical spine contains many different anatomic compositions, including muscles, bones, ligaments, and joints. All of these structures have nerve endings that can detect painful problems when they occur. Such nerves supply muscular control and sensations to the skull and arms while correspondingly providing our bodies with flexibility and motion. [1] However, if the cervical spine is injured it can cause many minor or traumatic problems, and although these injuries vary specifically they are more commonly known as "cervical spine disorders" as a whole. [1]

Symptoms

It is through upper frontal chest discomfort (also known as cervical angina) and scapular pains which signs of cervical spine disorders are shown. In 1937 a man named Oille was the first to state that these chest pains originated from the cervical nerve root. [2] This new outlook helped shed light on exactly what signs indicated the beginning of these ailments for those with cervical spine disorders. It is now recognized that these patients feel pain, numbness, discomfort, and weakness along with neurological symptoms. [2]

Complications

If not treated right away, there are many consequences and pains various cervical spine disorders can cause. [1]

Brachial plexus Gray808.png
Brachial plexus

Cause

There are several conditions and syndromes that can affect the cervical spine and they all vary due to the difference in place and type of injury.

Age factors

Diagnosis

The diagnosis process might include a physician who tests that the movement, strength, and sensation of the arms and legs are normal. The spine is examined for its range of motion and any pain that may arise from movement. Blood work might be utilized in addition to radiographic imaging in order to identify spinal cord diseases. Basic imaging techniques, which includes x-ray imaging, can reveal degenerative changes of the spine, while more advanced imaging techniques, such as computed tomography (CT) and magnetic resonance imaging (MRI), can allow visualization of more detailed anatomical structures, including that of the associated nerves and muscles. The most detailed and specific testing is electrodiagnostic, which helps to uncover whether the appropriate electrical signals are being sent to each muscle from the correlate nerves. This aids in localizing a problem's source. [1] There are risks to be considered with any diagnostic testing. For example, in the case of CT imaging, there is obvious benefit over x-ray in that a more thorough picture of the anatomy is exposed, but there is a trade-off in that CT has around a 10-fold increased radiation exposure; alternatively, while MRI provides highly detailed imaging of the anatomy with the benefit of no radiation exposure to the patient, the high cost of this test must be taken into account. [6]

Treatments

If one's symptoms are mild, treatments like Massage, Exercise, and Stress management will suffice in reducing pain and pressure, but those with more severe symptoms are told to undergo unique therapies based on their exact situation. These patients most likely will have their postures and spine alignment fixed, and/or treatments like electrical stimulation may be used to help in reducing pain and aid in flexibility. Medicine, epidural injections and surgeries are also implemented to treat such a disorder. [1]

See also

Related Research Articles

Syringomyelia Disorder in which a cyst forms in the spinal cord

Syringomyelia is a generic term referring to a disorder in which a cyst or cavity forms within the spinal cord. Often, syringomyelia is used as a generic term before an etiology is determined. This cyst, called a syrinx, can expand and elongate over time, destroying the spinal cord. The damage may result in loss of feeling, paralysis, weakness, and stiffness in the back, shoulders, and extremities. Syringomyelia may also cause a loss of the ability to feel extremes of hot or cold, especially in the hands. It may also lead to a cape-like bilateral loss of pain and temperature sensation along the upper chest and arms. Each patient experiences a different combination of symptoms. These symptoms typically vary depending on the extent and, often more critically, on the location of the syrinx within the spinal cord.

Brachial plexus Network of nerves

The brachial plexus is a network of nerves formed by the anterior rami of the lower four cervical nerves and first thoracic nerve. This plexus extends from the spinal cord, through the cervicoaxillary canal in the neck, over the first rib, and into the armpit. It supplies afferent and efferent nerve fibers to the chest, shoulder, arm, forearm, and hand.

Lumbar spinal stenosis Medical condition of the spine

Lumbar spinal stenosis (LSS) is a medical condition in which the spinal canal narrows and compresses the nerves and blood vessels at the level of the lumbar vertebrae. Spinal stenosis may also affect the cervical or thoracic region, in which case it is known as cervical spinal stenosis or thoracic spinal stenosis. Lumbar spinal stenosis can cause pain in the low back or buttocks, abnormal sensations, and the absence of sensation (numbness) in the legs, thighs, feet, or buttocks, or loss of bladder and bowel control.

Spondylosis Degeneration of the vertebral column.

Spondylosis is the degeneration of the vertebral column from any cause. In the more narrow sense it refers to spinal osteoarthritis, the age-related wear and tear of the spinal column, which is the most common cause of spondylosis. The degenerative process in osteoarthritis chiefly affects the vertebral bodies, the neural foramina and the facet joints. If severe, it may cause pressure on the spinal cord or nerve roots with subsequent sensory or motor disturbances, such as pain, paresthesia, imbalance, and muscle weakness in the limbs.

Degenerative disc disease Medical condition

Degenerative disc disease (DDD) is a medical condition typically brought on by the normal aging process in which there are anatomic changes and possibly a loss of function of one or more intervertebral discs of the spine. DDD can take place with or without symptoms, but is typically identified once symptoms arise. The root cause is thought to be loss of soluble proteins within the fluid contained in the disc with resultant reduction of the oncotic pressure, which in turn causes loss of fluid volume. Normal downward forces cause the affected disc to lose height, and the distance between vertebrae is reduced. The anulus fibrosus, the tough outer layers of a disc, also weakens. This loss of height causes laxity of the longitudinal ligaments, which may allow anterior, posterior, or lateral shifting of the vertebral bodies, causing facet joint malalignment and arthritis; scoliosis; cervical hyperlordosis; thoracic hyperkyphosis; lumbar hyperlordosis; narrowing of the space available for the spinal tract within the vertebra ; or narrowing of the space through which a spinal nerve exits with resultant inflammation and impingement of a spinal nerve, causing a radiculopathy.

In medicine, a stinger, also called a burner or nerve pinch injury, is a neurological injury suffered by athletes, mostly in high-contact sports such as ice hockey, rugby, American football, and wrestling. The spine injury is characterized by a shooting or stinging pain that travels down one arm, followed by numbness and weakness in the parts of the arms, including the biceps, deltoid, and spinati muscles. Many athletes in contact sports have suffered stingers, but they are often unreported to medical professionals.

Nerve conduction study Diagnostic test for nerve function

A nerve conduction study (NCS) is a medical diagnostic test commonly used to evaluate the function, especially the ability of electrical conduction, of the motor and sensory nerves of the human body. These tests may be performed by medical specialists such as clinical neurophysiologists, physical therapists, chiropractors, physiatrists, and neurologists who subspecialize in electrodiagnostic medicine. In the United States, neurologists and physiatrists receive training in electrodiagnostic medicine as part of residency training and in some cases acquire additional expertise during a fellowship in clinical neurophysiology, electrodiagnostic medicine, or neuromuscular medicine. Outside the US, clinical neurophysiologists learn needle EMG and NCS testing.

Middle back pain, also known as thoracic back pain, is back pain that is felt in the region of the thoracic vertebrae, which are between the bottom of the neck and top of the lumbar spine. It has a number of potential causes, ranging from muscle strain to collapse of a vertebra or rare serious diseases. The upper spine is very strong and stable to support the weight of the upper body, as well as to anchor the rib cage which provides a cavity to allow the heart and lungs to function and protect them.

Spinal disc herniation Injury to the connective tissue between spinal vertebrae

Spinal disc herniation is an injury to the cushioning and connective tissue between vertebrae, usually caused by excessive strain or trauma to the spine. It may result in back pain, pain or sensation in different parts of the body, and physical disability. The most conclusive diagnostic tool for disc herniation is MRI, and treatment may range from painkillers to surgery. Protection from disc herniation is best provided by core strength and an awareness of body mechanics including posture.

Radiculopathy Medical condition

Radiculopathy, also commonly referred to as pinched nerve, refers to a set of conditions in which one or more nerves are affected and do not work properly. Radiculopathy can result in pain, weakness, altered sensation (paresthesia) or difficulty controlling specific muscles. Pinched nerves arise when surrounding bone or tissue, such as cartilage, muscles or tendons, put pressure on the nerve and disrupt its function.

Orthopedic pathology

Orthopedic pathology, also known as bone pathology is a subspecialty of surgical pathology which deals with the diagnosis and feature of many bone diseases, specifically studying the cause and effects of disorders of the musculoskeletal system. It uses gross and microscopic findings along with the findings of in vivo radiological studies, and occasionally, specimen radiographs to diagnose diseases of the bones.

Neck pain Medical condition

Neck pain, also known as cervicalgia, is a common problem, with two-thirds of the population having neck pain at some point in their lives.

Neurogenic claudication Medical condition

Neurogenic claudication (NC), also known as pseudoclaudication, is the most common symptom of lumbar spinal stenosis (LSS) and describes intermittent leg pain from impingement of the nerves emanating from the spinal cord. Neurogenic means that the problem originates within the nervous system. Claudication, from the Latin word for to limp, refers to painful cramping or weakness in the legs. NC should therefore be distinguished from vascular claudication, which stems from a circulatory problem rather than a neural one.

Laminoplasty

Laminoplasty is an orthopaedic/neurosurgical surgical procedure for treating spinal stenosis by relieving pressure on the spinal cord. The main purpose of this procedure is to provide relief to patients who may suffer from symptoms of numbness, pain, or weakness in arm movement. The procedure involves cutting the lamina on both sides of the affected vertebrae and then "swinging" the freed flap of bone open thus relieving the pressure on the spinal cord. The spinous process may be removed to allow the lamina bone flap to be swung open. The bone flap is then propped open using small wedges or pieces of bone such that the enlarged spinal canal will remain in place.

Spinal disease

Spinal disease refers to a condition impairing the backbone. These include various diseases of the back or spine ("dorso-"), such as kyphosis. Dorsalgia refers to back pain. Some other spinal diseases include spinal muscular atrophy, ankylosing spondylitis, lumbar spinal stenosis, spina bifida, spinal tumors, osteoporosis and cauda equina syndrome.

Basilar invagination is invagination (infolding) of the base of the skull that occurs when the top of the C2 vertebra migrates upward. It can cause narrowing of the foramen magnum. It also may press on the lower brainstem.

Spinal stenosis Disease of the bony spine that results in narrowing of the spinal canal

Spinal stenosis is an abnormal narrowing of the spinal canal or neural foramen that results in pressure on the spinal cord or nerve roots. Symptoms may include pain, numbness, or weakness in the arms or legs. Symptoms are typically gradual in onset and improve with bending forwards. Severe symptoms may include loss of bladder control, loss of bowel control, or sexual dysfunction.

Cancer pain can be caused by pressure on, or chemical stimulation of, specialised pain-signalling nerve endings called nociceptors, or by damage or illness affecting nerve fibers themselves.

Cervicocranial syndrome Medical condition

Cervicocranial syndrome or is a neurological illness. It is a combination of symptoms that are caused by an abnormality in the neck. The bones of the neck that are affected are cervical vertebrae. This syndrome can be identified by confirming cervical bone shifts, collapsed cervical bones or misalignment of the cervical bone leading to improper functioning of cervical spinal nerves. Cervicocranial syndrome is either congenital or acquired. Some examples of diseases that could result in cervicocranial syndrome are Chiari disease, Klippel-Feil malformation osteoarthritis, and trauma. Treatment options include neck braces, pain medication and surgery. The quality of life for individuals suffering from CCJ syndrome can improve through surgery.

Craniocervical instability is a medical condition where there is excessive movement of the vertebrae at the atlanto-occipital joint and the atlanto-axial joint, that is, between the skull and the top two vertebrae. This can cause neuronal injury and compression of nearby structures including the spinal cord, brain stem, vertebral artery or vagus nerve, causing a constellation of symptoms. It is frequently co-morbid with atlanto-axial instability, Chiari malformation and tethered cord syndrome.

References

  1. 1 2 3 4 5 6 7 8 9 "Neck Pain and Cervical Spine Disorders". Minneapolis Clinic of Neurology.
  2. 1 2 Nakajima, H; Uchida, K; Kobayashi, S; Kokubo, Y; Yayama, T; Sato, R; Inukai, T; Godfrey, T; Baba, H (6 December 2005). "Cervical angina: a seemingly still neglected symptom of cervical spine disorder?". Spinal Cord. 44 (8): 509–513. doi: 10.1038/sj.sc.3101888 . PMID   16331305. ProQuest   229343382.
  3. 1 2 3 4 5 Cervical spine disorder. "Medtronic". Retrieved from http://wwwp.medtronic.com/Newsroom/LinkedItemDetails.do?itemId=1169645895363&itemType=backgrounder&lang=en_IN Archived 2016-03-04 at the Wayback Machine
  4. Hermann, Karl M; Reese, C Shane (1 March 2001). "Relationships Among Selected Measures of Impairment, Functional Limitation, and Disability in Patients With Cervical Spine Disorders". Physical Therapy. 81 (3): 903–912. doi: 10.1093/ptj/81.3.903 . PMID   11268155. ProQuest   223115626.
  5. 1 2 Neo, Masashi (15 April 2008). "Treatment of upper cervical spine involvement in rheumatoid arthritis patients". Modern Rheumatology. 18 (4): 327–335. doi:10.1007/s10165-008-0059-7. PMID   18414784. ProQuest   232743067.
  6. 1 2 Dormans, John P. (January 2002). "Evaluation of Children with Suspected Cervical Spine Injury". The Journal of Bone and Joint Surgery. American Volume. 84 (1): 124–132. doi:10.2106/00004623-200201000-00018. PMID   11792790. ProQuest   205129467.
  7. McCormick, M T; Robinson, H K; Bone, I; McLean, A N; Allan, D B (28 November 2006). "Blunt cervical spine trauma as a cause of spinal cord injury and delayed cortical blindness". Spinal Cord. 45 (10): 687–689. doi: 10.1038/sj.sc.3101995 . PMID   17130891. ProQuest   229343756.
  8. Degenerative spine disorders. Retrieved from http://neurosurgery.ucsf.edu/index.php/spine_disorders_cervical.html Archived 2014-06-05 at the Wayback Machine

Further reading