Cervical Spine

Cervical spine disease refers to a wide range of medical conditions that affect the cervical spine, which is the portion of the spine located in the neck.

The cervical spine consists of seven vertebrae (C1 to C7) and plays a crucial role in supporting the head, protecting the spinal cord, and facilitating neck movement. Various factors, including aging, trauma, and degenerative changes, can contribute to cervical spine diseases.

Overview of Conditions

Overview of common cervical spine conditions, along with their causes, symptoms, and treatment options:

  • Causes: Natural aging process where discs lose hydration and elasticity.
  • Symptoms: Chronic neck pain, stiffness, and sometimes pain that radiates to the arms or shoulders.
  • Treatment: Physical therapy, NSAIDs, muscle relaxants, steroid injections, and in severe cases, surgery.
  • Cause: A herniated or bulging disc in the cervical spine, usually resulting from age-related changes, injury, or excessive strain.
  • Symptoms: Neck pain, along with radiating pain, numbness, or weakness in the arm and hand. Sometimes, it can compress the spinal cord, causing myelopathy.
  • Treatment: Conservative methods like rest, physical therapy, and epidural steroid injections. Surgery may be considered for persistent or severe cases.
  • Causes: The synovium, a thin layer of tissue lining the joints, becomes inflamed and thickened. This inflammation can erode bone, cartilage, and ligaments, causing joint instability.
  • Symptoms: Neck pain, stiffness, limited range of motion in the neck, headaches or occipital pain, neurological symptoms due to spinal cord compression, such as weakness, numbness, tingling in the limbs, difficulty walking, loss of bowel or bladder control.
  • Treatment: NSAIDs, steroid injections, cervical collar, antirheumatic drugs, and in severe cases, surgery.
  • Cause: Age-related wear and tear of the cervical spine, leading to the degeneration of discs and joints.
  • Symptoms: Neck pain, stiffness, and reduced range of motion. In severe cases, it can cause nerve compression, leading to radiating arm pain or weakness.
  • Treatment: Conservative approaches like physical therapy, pain management, and anti-inflammatory medications. In some cases, surgery may be necessary to decompress nerve roots.
  • Cause: Compression or irritation of a nerve root in the cervical spine, often due to a herniated disc, bone spur, or spinal stenosis.
  • Symptoms: Radiating pain, numbness, tingling, or weakness in the neck, shoulder, arm, or hand, often following a specific nerve pathway.
  • Treatment: Initially managed with rest, physical therapy, and pain medications. Severe cases may require surgical decompression.
  • Cause: Narrowing of the spinal canal in the cervical region, often due to age-related changes or congenital factors.
  • Symptoms: Neck pain, weakness, numbness, and clumsiness in the hands. Severe cases can lead to myelopathy, which may affect the legs as well.
  • Treatment: Conservative management and physical therapy are common. Surgery may be necessary for significant stenosis.
  • Cause: Compression of the spinal cord in the cervical spine, typically due to herniated discs, bone spurs, or spinal stenosis.
  • Symptoms: Progressive weakness, balance problems, coordination difficulties, and changes in bowel or bladder function.
  • Treatment: Surgery is often recommended to decompress the spinal cord and stabilise the cervical spine.
  • Cause: Traumatic injuries such as car accidents, falls, or sports-related accidents.
  • Symptoms: Severe neck pain, swelling, deformity, and sometimes neurological deficits.
  • Treatment: Immobilisation with a brace or surgical intervention, depending on the severity of the fracture.
  • Cause: Overuse, muscle spasms, or minor injuries to the neck muscles and ligaments.
  • Symptoms: Localised neck pain, stiffness, and muscle tenderness.
  • Treatment: Rest, ice, heat, over-the-counter pain relievers, and physical therapy.
  • Causes: Rapid forward and backward motion of the neck, usually from car accidents.
  • Symptoms: Neck pain and stiffness, headache, dizziness, blurred vision, fatigue.
  • Treatment: Pain relief medications, muscle relaxants, physical therapy, cervical collar.

Dr Richard Parkinson practices the latest minimally-invasive surgical techniques when performing cervical spine surgery, such as tubular microdiscectomy (keyhole retractor surgery using a powerful operative microscope) as well as the ultra-minimally-invasive percutaneous discectomy (keyhole endoscopic surgery).

Cervical spine injuries, although uncommon, can result in significant and long-term disability. It is essential to consult a healthcare professional for an accurate diagnosis and appropriate treatment plan if you suspect any cervical spine condition as some conditions can cause permanent nerve and spinal cord injury if left untreated, which can result in long-term disability and permanently impaired movement. Treatment options vary depending on the specific condition, its severity, and the patient’s overall health.

Overview of Surgical Procedures

If you have a cervical spine disease that is causing damage to your nerves or spinal cord and surgery is recommended, it is likely you will end up having at least one of the following procedures:

  • Percutaneous Endoscopic Cervical Surgery (Ultra-Minimally-Invasive)
  • Cervical Spine Decompression (Anterior or Posterior)
  • Cervical Microdiscectomy (Microdecompression)
  • Anterior Cervical Discectomy and Fusion (ACDF)
  • Cervical Laminectomy / Laminotomy
  • Cervical Laminoplasty
  • Cervical Foraminotomy
  • Cervical Fusion (Anterior or Posterior)
  • Anterior Cervical Corpectomy and Fusion (ACCF)
  • Posterior Cervical Laminectomy and Fusion
  • Posterior Cervical Laminectomy and Foraminotomy (PCLF)
  • Cervical Artificial Disc Arthroplasty (Replacement)
  • Cervical Corpectomy
  • Cervical Posterior Foraminotomy
  • Cervical Nerve Root Decompression
  • Cervical Spine Fracture Fixation
  • Cervical Osteotomy
  • Occipitocervical Fusion (OCF)
  • Posterior Cervical Fusion (PCF)
  • Cervical Nerve Root Block
  • Tumour Resection
  • Cervical Revision Surgery

A/Prof Richard Parkinson

MBBS, BMedSci, FRACS

Neurosurgeon & Spine Surgeon with 25+ Years Experience

A/Prof Richard Parkinson performs surgery at Sydney’s leading private hospitals.

He consults and operates from Sydney’s most advanced neurosurgical and spinal surgery hospitals, including St Vincent’s Private Hospital, Prince of Wales Private Hospital and The Mater Hospital.

These hospitals offer the latest neurosurgical facilities, including cutting-edge imaging equipment and surgical navigation systems, dedicated and well-trained theatre clinical staff, as well as post-surgical rehabilitation specialists.

A/Prof Parkinson’s areas of expertise include surgery of the entire spinal column, scoliosis surgery, peripheral nerve surgery, as well as physical rehabilitation of athletes that have suffered a brain or spine injury.

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