Degenerative cervical spine disease - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Degenerative cervical spine disease (cervical spondylosis) is osteoarthritis of the spine, which includes the spontaneous degeneration of either disk or facet joints.
Presenting symptoms include axial neck pain and neurologic complications.
The most common neurologic complication is cervical spondylotic radiculopathy. This results in a pattern of arm pain (specific to the nerve root involved) along with mild weakness and sensory loss in muscles and skin innervated by that nerve root.
The next most common neurologic complication is loss of neurologic function from pressure on the spinal cord in the cervical region (degenerative cervical myelopathy). Although this loss of function can be painful, there is usually a painless reduction of upper extremity (and sometimes lower extremity) function, which is particularly noticeable as hand clumsiness or loss of fine motor function.
Treatments differ radically depending on patient presentation, specific symptoms, and which arthritis-related or neurologic complications predominate.

Severe, multilevel degenerative disk disease changes but without significant spinal cord compression (i.e., neither deformation nor intrinsic T2 changes) on cervical MRI (sagittal T2)

Dennis A. Turner, MA, MD

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Definition

Epidemiology

Etiology

Pathophysiology

Images

Severe, multilevel degenerative disk disease changes but without significant spinal cord compression (i.e., neither deformation nor intrinsic T2 changes) on cervical MRI (sagittal T2)
Cervical MRI (sagittal T2) with mild degenerative joint disease and disk bulging
Cervical MRI (sagittal T2) with moderate degenerative joint disease but no significant spinal cord compression
Diagram of subsets of cervical spondylosis, including various symptoms possibly arising within the larger field of asymptomatic (radiographic) spondylosis
A single level of spinal cord compression with T2 changes, on cervical sagittal T2 sequence in the presence of symptomatic degenerative cervical myelopathy
Previous spinal cord compression at C3/4 on sagittal T2 MRI, with residual T2 changes, and new compression at C2/3 and C6/7, with T2 changes
Chart showing average dermatome size and location. Radicular pain is usually confined to a single dermatome

Citations

Key Articles

Mazanec D, Reddy A. Medical management of cervical spondylosis. Neurosurgery. 2007 Jan;60(1 suppl 1):S43-50.[Abstract]
Joint Section on Disorders of the Spine and Peripheral Nerves of the American Association of Neurological Surgeons and Congress of Neurological Surgeons. Guidelines for the surgical management of cervical degenerative disease. 2009 [internet publication].
Nikolaidis I, Fouyas IP, Sandercock PA, et al. Surgery for cervical radiculopathy or myelopathy. Cochrane Database Syst Rev. 2010 Jan 20;(1):CD001466.[Abstract][Full Text]
North American Spine Society. Diagnosis and treatment of cervical radiculopathy from degenerative disorders. 2010 [internet publication].[Full Text]
Graham N, Gross A, Goldsmith CH, et al. Mechanical traction for neck pain with or without radiculopathy. Cochrane Database Syst Rev. 2008 Jul 16;(3):CD006408.[Abstract][Full Text]
Gao F, Mao T, Sun W, et al. An updated meta-analysis comparing artificial cervical disc arthroplasty (CDA) versus anterior cervical discectomy and fusion (ACDF) for the treatment of cervical degenerative disc disease (CDDD). Spine (Phila Pa 1976). 2015 Dec;40(23):1816-23.[Abstract]

Referenced Articles

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