As we age, our vertebral discs, which serve as shock absorbers for the spine, gradually dry out, affecting their strength and resiliency. This can lead to degenerative disc disease (DDD). DDD of the cervical spine is a relatively common condition for aging adults. However, many people who have cervical degenerative disc disease don't even know it. They may only become aware of the condition when being examined for another health problem or during a routine checkup.

Symptoms of Cervical DDD

Disc degeneration is a normal part of aging, and is not usually a problem. However, DDD can cause the discs to lose height and to become stiff. When disc height is lost, nerve impingement, bone and joint inflammation, and resultant pain can occur. Disc degeneration causes "bone on bone" like arthritis pain and inflammation. In severe cases, this pain may be constant.

Diagnosing Cervical DDD

All effective treatments are built upon accurate diagnosis. The physicians at CCSI utilize a combination of their expertise and state-of-the-art diagnostic technology to ensure a correct diagnosis. The diagnostic process includes:

• Medical history. We will talk to you about your symptoms, how severe they are, and what treatments you have already tried.
  
  
• Physical examination. You will be carefully examined by one of our spine specialists for limitations of movement, problems with balance, and pain. During this exam, we will also look for loss of reflexes in the extremities, muscle weakness, loss of sensation or other signs of neurological damage.
  
  
• Diagnostic tests. Generally, we start with plain x-rays, which allow us to rule out other problems such as tumors and infections. The x-rays also allow us to see if there is any loss of disc space between the vertebrae. In some cases we also use a test called a discography to confirm the diagnosis. This test involves injecting contrast dye into the affected disc (or discs) to create a clearer image.

Treatment of Cervical DDD

For acute or sudden neck pain, we can prescribe pain relief medications such as acetaminophen, anti-inflammatory agents, and muscle relaxants. Temporary bed rest may also be suggested. But patients are encouraged to get up and gradually increase their activities of daily living.

At CCSI, we believe strongly in continuing your treatment even after you leave our facility. That is why we prescribe physical therapy for patients who can benefit from it. For cervical DDD, prescribed stretching exercises can improve flexibility and extension exercises help maintain the spine's natural curve. A hot/cold therapy and gentle massage can also be very beneficial for neck pain. Chiropractic care will also be considered at this time.

After acute symptoms subside (usually within two to three weeks), patients are encouraged to begin a daily exercise regimen. This may include low impact aerobics three times per week as well as daily neck exercises.

If symptoms of cervical DDD persist despite these non-operative treatments, further diagnostic tests may be necessary. These tests may include an MRI, CT Scan, Myelogram, or possibly Discography.

MRI showing herniated cervical disc

If the surgeon discovers that one or more of the vertebral discs have herniated, surgery may be necessary. Your surgeon will consider various surgical options. A common technique at CCSI is an anterior cervical discectomy and fusion (ACDF). This involves an anterior (from the front) approach, removal of the offending disc and then fusion of the adjacent vertebrae usually with instrumentation. However, there are also other surgical options that will be considered, and your surgeon will carefully discuss these with you.

Recovery

While cervical DDD is a natural part of aging, it does not mean you have to live with neck pain. We can help you return to a healthy, pain-free and active life. For most patients this can be accomplished with non-surgical treatments. But even if surgery is needed, be assured that we will discuss with you all aspects of the procedure and provide you with the best care possible.