By Amanda N. Sacino, MD-PhD . Neurosurgeon and Managing Partner
The cervical spine, comprising seven vertebrae in the neck region, serves as a crucial support structure for the head and facilitates intricate movements. Despite its paramount importance, various factors such as age, injuries, or degenerative changes can give rise to cervical spine issues. This article aims to delve extensively into three prevalent conditions affecting the cervical spine: cervical stenosis, cervical radiculopathy, and cervical myelopathy.
Cervical Stenosis
Cervical stenosis, characterized by the narrowing of the spinal canal in the neck region, arises from diverse causes, including age-related changes, herniated discs, or the presence of bone spurs. The narrowing of the spinal canal can exert pressure on the spinal cord and nerve roots, resulting in symptoms such as neck pain, stiffness, and numbness or weakness in the arms and hands.
Age-related changes play a significant role in cervical stenosis, marked by the formation of bone spurs and the thickening of ligaments. These alterations gradually reduce the space available for the spinal cord and nerves, leading to compression and associated symptoms. Individuals may also experience a decrease in the range of motion.
Treatment for cervical stenosis encompasses a spectrum of options. Conservative measures include physical therapy, anti-inflammatory medications, targeted epidural steroid injections, and lifestyle modifications to alleviate symptoms. However, in cases where patients experience significant symptoms despite these measures, surgical interventions become a viable option. Procedures like decompression surgery or spinal fusion aim to alleviate pressure on the spinal cord and nerves while providing stability to the spine. Notably, studies suggest that surgery need not be prophylactic in patients with stenosis on imaging, but no or mild symptoms.
Cervical Radiculopathy
Cervical radiculopathy results from the compression or irritation of nerve roots in the cervical spine, often caused by herniated discs, bone spurs, or degenerative changes. The primary symptom is pain radiating from the neck into the shoulder, arm, and sometimes the hand, accompanied by numbness, tingling, and weakness in the affected arm.
Herniated discs, characterized by the protrusion of the soft inner material through the tougher outer layer, can compress nearby nerve roots, causing radiculopathy. Similarly, bone spurs or degenerative changes can impinge on nerve roots, leading to a spectrum of symptoms that significantly impact an individual’s daily life.
Non-surgical treatments for cervical radiculopathy offer a range of options. Rest, physical therapy, and targeted epidural steroid injections aim to reduce inflammation and alleviate symptoms. Additionally, medications such as non-steroidal anti-inflammatory drugs (NSAIDs) and pain relievers may be prescribed. However, when conservative measures fail to provide relief, surgical options become a consideration to relieve pressure on the affected nerve roots and restore functionality.
Cervical Myelopathy
Cervical myelopathy involves the compression of the spinal cord in the neck region, often due to degenerative changes, herniated discs, or spinal cord injuries. Symptoms vary but commonly include difficulty walking, coordination problems, hand clumsiness, and weakness.
Degenerative changes, such as ligament thickening or the development of bone spurs, contribute to spinal canal narrowing and spinal cord compression in cervical myelopathy. Herniated discs may also play a significant role if displaced disc material compresses the spinal cord, leading to a cascade of neurological symptoms.
Treatment for cervical myelopathy necessitates a comprehensive approach. Conservative measures, including physical therapy and medications, aim to manage symptoms and improve functional capacity. In cases where conservative approaches prove insufficient, surgical interventions become pivotal. Procedures such as spinal decompression or fusion surgery may be recommended to alleviate pressure on the spinal cord and address the underlying causes. The decision for surgery is carefully considered based on the severity of symptoms, overall health, and individual patient factors.
Conclusion
A comprehensive understanding of common cervical spine issues, including cervical stenosis, cervical radiculopathy, and cervical myelopathy, is crucial for early detection and effective management. Individuals experiencing persistent neck pain, radiating symptoms, or neurological deficits should seek consultation with a neurosurgeon to determine the underlying cause and explore appropriate treatment options. Whether through conservative measures or surgical interventions, addressing cervical spine issues promptly can significantly improve outcomes and enhance overall quality of life. In this rapidly evolving field, personalized treatment plans continue to emerge, ensuring that individuals receive the most effective and tailored care for their specific cervical spine conditions. To learn more or to schedule an appointment for you or your loved, call 239-422-2739.
About Amanda Sacino, MD, PhD
Dr. Sacino was born and raised on the east coast of Florida. After securing her undergraduate degree at Boston Unversity, she returned to her home state and attended the University of Florida, where she obtained her medical and post-doctorate degrees.
Her PhD work focused on proteinopathies, mainly Parkinsonism. But her mentors recognized her surgical precision skills, and so Dr. Sacino pursued extensive training in cranial, spine, and peripheral nerve surgery at Johns Hopkins Hospital. From there, she completed two spine fellowships at Johns Hopkins Hospital and the Swedish Neuroscience Institute. Her surgical spine training includes experience with degenerative diseases, congenital diseases, deformity, oncology, and trauma.
Dr. Sacino trained under Dr. Nicholas Theodore, the inventor of the Globus ExcelsiusGPS robot. She was present during the first robotic surgery at Johns Hopkins and trained extensively for five years with the robot during both spine and cranial cases.
Dr. Sacino’s high standards and pursuit of quality has led her to become well-respected by her mentors and peers. Her goal is to provide patients with case-specific solutions so they have all the information and options they need to make informed decisions.
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