Skip to main content
Top
Published in: Current Reviews in Musculoskeletal Medicine 4/2011

01-12-2011 | Spine (Matthew Cunningham, Section Editor)

Cervical spine: degenerative conditions

Author: Andrew G. Todd

Published in: Current Reviews in Musculoskeletal Medicine | Issue 4/2011

Login to get access

Abstract

Degenerative cervical spine disorders will affect up to two-thirds of the population in their lifetime. While often benign and episodic in nature, cervical disorders may become debilitating resulting in severe pain and possibly neurologic sequelae. Non-operative treatment continues to play an important role in treating these patients, with medications, therapy and interventional pain injections playing increasing roles in treatment. Surgical treatment including anterior and posterior decompression and fusion have been effective treatments of many cervical disorders, but may lead to significant problems including adjacent level disease. Laminotomy/foraminotomy and total disc arthroplasty may avoid some of these problems while providing similar clinical results. Ongoing clinical trials and studies are helping to define the role of these new technologies in treatment of patients with degenerative cervical disorders, although their greater benefit has yet to be proven.
Literature
1.
go back to reference Lawrence JS. Disc degeneration: its frequency in relationship to symptoms. Ann Rheum Dis. 1969;28:121–37.PubMedCrossRef Lawrence JS. Disc degeneration: its frequency in relationship to symptoms. Ann Rheum Dis. 1969;28:121–37.PubMedCrossRef
2.
go back to reference Cote P, Cassidy JD, Carroll L. The Seskatchewan health and back pain survey: the prevalence of neck pain and related disability in Saskatchewan adults. Spine. 1998;23:1689–98.PubMedCrossRef Cote P, Cassidy JD, Carroll L. The Seskatchewan health and back pain survey: the prevalence of neck pain and related disability in Saskatchewan adults. Spine. 1998;23:1689–98.PubMedCrossRef
3.
go back to reference Guez M, Hildingsson C, Nilsson M, et al. The prevalence of neck pain: a population based study from Northern Sweden. Acta Orthop Scand. 2002;73:455–9.PubMedCrossRef Guez M, Hildingsson C, Nilsson M, et al. The prevalence of neck pain: a population based study from Northern Sweden. Acta Orthop Scand. 2002;73:455–9.PubMedCrossRef
4.
go back to reference Cote P, Cassidy JD, Carroll L. The factors associated with neck pain and its related disability in the Saskatchewan population. Spine. 2000;25:1109–17.PubMedCrossRef Cote P, Cassidy JD, Carroll L. The factors associated with neck pain and its related disability in the Saskatchewan population. Spine. 2000;25:1109–17.PubMedCrossRef
5.
go back to reference Salemi G, Savettieri G, Meneghini F, et al. Prevalence of cervical spondylitic radiculopathy: a door-to-door survey in a Sicilian municipality. Acta Neurol Acand. 1996;93:184–8.CrossRef Salemi G, Savettieri G, Meneghini F, et al. Prevalence of cervical spondylitic radiculopathy: a door-to-door survey in a Sicilian municipality. Acta Neurol Acand. 1996;93:184–8.CrossRef
6.
go back to reference Radhakrishnan K, Litchy WJ, O’Fallon M, Kurland LT. Epidemiology of cervical radiculopathy: a population based study from Rochester, Minnesota, 1976 through 1990. Brain. 1994;117:325–55.PubMedCrossRef Radhakrishnan K, Litchy WJ, O’Fallon M, Kurland LT. Epidemiology of cervical radiculopathy: a population based study from Rochester, Minnesota, 1976 through 1990. Brain. 1994;117:325–55.PubMedCrossRef
7.
go back to reference DePalma AF, Subin DK. Study of the cervical syndrome. Clin Orthop. 1965;38:135–42.PubMed DePalma AF, Subin DK. Study of the cervical syndrome. Clin Orthop. 1965;38:135–42.PubMed
8.
go back to reference Rothman RH, Rashbaum RF. Pathogenesis of signs and symptoms of cervical disc degeneration. Instr Course Lect. 1978;27:203–15. Rothman RH, Rashbaum RF. Pathogenesis of signs and symptoms of cervical disc degeneration. Instr Course Lect. 1978;27:203–15.
9.
go back to reference Gore DR, Sepic SB, Gardener GM, Murray MP. Neck pain: a long term follow-up of 205 patients. Spine. 1987;12:1–5.PubMedCrossRef Gore DR, Sepic SB, Gardener GM, Murray MP. Neck pain: a long term follow-up of 205 patients. Spine. 1987;12:1–5.PubMedCrossRef
10.
go back to reference Epstien JA, Epstein WE: The surgical management of cervical spinal stenosis, spondylosis, and myeloradiculopathy by means of the posterior approach. In Cervical Spine Research Society: The Cervical Spine. Philadelphia, JB Lippincott, 1989. Epstien JA, Epstein WE: The surgical management of cervical spinal stenosis, spondylosis, and myeloradiculopathy by means of the posterior approach. In Cervical Spine Research Society: The Cervical Spine. Philadelphia, JB Lippincott, 1989.
11.
go back to reference Clark E, Robinson PK. Cervical Myelopathy: a complication of cervical spondylosis. Brain. 1956;1956:79483. Clark E, Robinson PK. Cervical Myelopathy: a complication of cervical spondylosis. Brain. 1956;1956:79483.
12.
go back to reference Boden S, McCown P, Davis D, Wiesel S. Abnormal magnetic resonance scans of the cervical spine in asymptomatic subjects. J Bone Joint Surg Am. 1990;72:1178–84.PubMed Boden S, McCown P, Davis D, Wiesel S. Abnormal magnetic resonance scans of the cervical spine in asymptomatic subjects. J Bone Joint Surg Am. 1990;72:1178–84.PubMed
13.
go back to reference Brower RS: Nonoperative management of Disc and Degenerative Disorders. In The Spine. Edited by Herkowitz H, Garfin S, Eismont F, et al. The Spine. Saunders Elsevier, 2006:814–818. Brower RS: Nonoperative management of Disc and Degenerative Disorders. In The Spine. Edited by Herkowitz H, Garfin S, Eismont F, et al. The Spine. Saunders Elsevier, 2006:814–818.
14.
go back to reference Dillin W, Uppal GS. Analysis if medications used in the treatment of cervical disk degeneration. Orthop Clin North Am. 1992;23:421–33.PubMed Dillin W, Uppal GS. Analysis if medications used in the treatment of cervical disk degeneration. Orthop Clin North Am. 1992;23:421–33.PubMed
15.
go back to reference Deyo R, Diehl A, Rosenthal M. How many days of bedrest for acute low back pain? a randomized clinical trial. N Engl J Med. 1976;20:557. Deyo R, Diehl A, Rosenthal M. How many days of bedrest for acute low back pain? a randomized clinical trial. N Engl J Med. 1976;20:557.
16.
go back to reference Philadelphia Panel Evidence-Based Clinical Practice Guidelines on Selective Rehabilitation Interventions for Neck Pain. Phys Ther 2001, 18:1701–1717. Philadelphia Panel Evidence-Based Clinical Practice Guidelines on Selective Rehabilitation Interventions for Neck Pain. Phys Ther 2001, 18:1701–1717.
17.
go back to reference DiFabio RP. Manipulation of the cervical spine: risks and benefits. Phys Ther. 1999;79:50–65. DiFabio RP. Manipulation of the cervical spine: risks and benefits. Phys Ther. 1999;79:50–65.
18.
go back to reference Manchikanti L, Cash KA, Pampati V, et al. The effectiveness of fluoroscopic cervical interlaminar epidural injections in management of chronic cervical disc herniation and radiculitis: preliminary results of a randomized, double-blind, contolled trial. Pain Phys. 2010;13:223–36. Manchikanti L, Cash KA, Pampati V, et al. The effectiveness of fluoroscopic cervical interlaminar epidural injections in management of chronic cervical disc herniation and radiculitis: preliminary results of a randomized, double-blind, contolled trial. Pain Phys. 2010;13:223–36.
19.
go back to reference Bush K, Hillier S. Outcome of cervical radiulopathy treated with periradiular/epidural corticosteroid injections: a prospective study with independent clinical review. Eur Spine J. 1996;5:319–25.PubMedCrossRef Bush K, Hillier S. Outcome of cervical radiulopathy treated with periradiular/epidural corticosteroid injections: a prospective study with independent clinical review. Eur Spine J. 1996;5:319–25.PubMedCrossRef
20.
go back to reference Ma DJ, Gila LA, Riew KD. Complications of fluoroscopically guided extraforamnal cervical nerve blocks: an analysis of 1036 injections. J Bone Joint Surg. 2005;87-A:1025–30.CrossRef Ma DJ, Gila LA, Riew KD. Complications of fluoroscopically guided extraforamnal cervical nerve blocks: an analysis of 1036 injections. J Bone Joint Surg. 2005;87-A:1025–30.CrossRef
21.
go back to reference Brouwers PJAM, Kottink EJBL, Dimone MAM, Prevo RL. A cervical anterior spinal artery syndrome after diagnostic blockade fo the right C6 nerve root. Pain. 2001;91:397–9.PubMedCrossRef Brouwers PJAM, Kottink EJBL, Dimone MAM, Prevo RL. A cervical anterior spinal artery syndrome after diagnostic blockade fo the right C6 nerve root. Pain. 2001;91:397–9.PubMedCrossRef
22.
go back to reference Rozin L, Rozin R, Koehler SA, et al. Death during transforaminal epidural steroid root block due to perforations of the left vertebral artery. Am J Forensic Med Pathol. 2003;24:351–5.PubMedCrossRef Rozin L, Rozin R, Koehler SA, et al. Death during transforaminal epidural steroid root block due to perforations of the left vertebral artery. Am J Forensic Med Pathol. 2003;24:351–5.PubMedCrossRef
23.
go back to reference Manchikanti L, Singh V, Falcon FJ, et al. Comparative Outcomes of a 2-year follow-up of cervical medial branch blocks in management of chronic neck pain: a randomized, double-blind controlled trial. Pain Phys. 2010;13:437–50. Manchikanti L, Singh V, Falcon FJ, et al. Comparative Outcomes of a 2-year follow-up of cervical medial branch blocks in management of chronic neck pain: a randomized, double-blind controlled trial. Pain Phys. 2010;13:437–50.
24.
go back to reference Wetzel FT. Chronic benign cervical pain syndromes. Surgical considerations Spine. 1992;17:S367–74. Wetzel FT. Chronic benign cervical pain syndromes. Surgical considerations Spine. 1992;17:S367–74.
25.
go back to reference Jagannathan J, Sherman JH, Szabo T, et al. The posterior cervical foraminotomy in the treatment of cervical disc/osteophyte disease:a single surgeon experience with a minimum of 5 years’ clinical and radiographic follow-up. J Neurosurg Spine. 2009;10:347–56.PubMedCrossRef Jagannathan J, Sherman JH, Szabo T, et al. The posterior cervical foraminotomy in the treatment of cervical disc/osteophyte disease:a single surgeon experience with a minimum of 5 years’ clinical and radiographic follow-up. J Neurosurg Spine. 2009;10:347–56.PubMedCrossRef
26.
go back to reference Clarke MJ, Ecker RD, Krauss WE, et al. Same-segment and adjacent level disease following posterior cervical foraminotomy. J Neurosurg Spine. 2007;6:5–9.PubMedCrossRef Clarke MJ, Ecker RD, Krauss WE, et al. Same-segment and adjacent level disease following posterior cervical foraminotomy. J Neurosurg Spine. 2007;6:5–9.PubMedCrossRef
27.
go back to reference Gala VC, O’Toole JE, Voyadis JM, Fessler RG. Posterior minimally invasive approaches for the cervical spine. Orthop Clin North Am. 2007;38:339–49.PubMedCrossRef Gala VC, O’Toole JE, Voyadis JM, Fessler RG. Posterior minimally invasive approaches for the cervical spine. Orthop Clin North Am. 2007;38:339–49.PubMedCrossRef
28.
go back to reference Harrop JS, Silva MT, Sharan AD, et al. Cervicothoracic radiulopathy treated using posterior cervical foraminotomy/discectomy. J Neurosurg. 2003;98S:131–6. Harrop JS, Silva MT, Sharan AD, et al. Cervicothoracic radiulopathy treated using posterior cervical foraminotomy/discectomy. J Neurosurg. 2003;98S:131–6.
29.
go back to reference Zeidman SM, Ducker TB. Posterior cervical laminoforaminotomy for radiculopathy: Review of 172 cases. Neurosurg. 1993;33:356–62.CrossRef Zeidman SM, Ducker TB. Posterior cervical laminoforaminotomy for radiculopathy: Review of 172 cases. Neurosurg. 1993;33:356–62.CrossRef
30.
go back to reference Faldini C, Leonetti D, Nanni M, et al. Cervical disc herniation and cervical spondylosis surgically treated by Cloward procedure: a 10-year minimum follow-up study. J Orthop Traumatol. 2010;11:99–103.PubMedCrossRef Faldini C, Leonetti D, Nanni M, et al. Cervical disc herniation and cervical spondylosis surgically treated by Cloward procedure: a 10-year minimum follow-up study. J Orthop Traumatol. 2010;11:99–103.PubMedCrossRef
31.
go back to reference Palma L, Mariottini A, Carangelo B, et al. Favourable long-term clinical outcome after anterior cervical discectomy. a study on a series of 125 patients undergoing surgery a mean of 11 years earlier. Acta Neurochir (Wien). 2010;152:1145–52.CrossRef Palma L, Mariottini A, Carangelo B, et al. Favourable long-term clinical outcome after anterior cervical discectomy. a study on a series of 125 patients undergoing surgery a mean of 11 years earlier. Acta Neurochir (Wien). 2010;152:1145–52.CrossRef
32.
go back to reference Papadopoulos EC, Huang RC, Girardi FP, et al. Three-level anterior cervical discectomy and fusion with plate fixation:radiographic and clinical results. Spine. 2006;31:897–902.PubMedCrossRef Papadopoulos EC, Huang RC, Girardi FP, et al. Three-level anterior cervical discectomy and fusion with plate fixation:radiographic and clinical results. Spine. 2006;31:897–902.PubMedCrossRef
33.
go back to reference Acharya S, Kumar S, Srivastava A, Tandon R. Early results of one-level discectomy and fusion with stand-alone cervical cage and bone marrow soaked tricalcium phosphate. Acta Ortho Belg. 2011;77:218–23. Acharya S, Kumar S, Srivastava A, Tandon R. Early results of one-level discectomy and fusion with stand-alone cervical cage and bone marrow soaked tricalcium phosphate. Acta Ortho Belg. 2011;77:218–23.
34.
go back to reference Schloz M, Schnake KJ, Pingel A, et al. A new zero-profile implant for stand-alone anterior cervical interbody fusion. Clin Orthop Relat Res. 2011;469:666–73.CrossRef Schloz M, Schnake KJ, Pingel A, et al. A new zero-profile implant for stand-alone anterior cervical interbody fusion. Clin Orthop Relat Res. 2011;469:666–73.CrossRef
36.
go back to reference •Yaremchuk KL, Toma MS, Somers ML, Peterson E: Acute airway obstruction in cervical spinal procedures with bone morphogenetic proteins. Laryngoscope 2010, 120:1954–7. Use of bone morpogenetic protein in anterior cervical procedures can lead to severe complications including airway obstruction, emergent need for reintubation and death. Its use should be avoided in such procedures. PubMedCrossRef •Yaremchuk KL, Toma MS, Somers ML, Peterson E: Acute airway obstruction in cervical spinal procedures with bone morphogenetic proteins. Laryngoscope 2010, 120:1954–7. Use of bone morpogenetic protein in anterior cervical procedures can lead to severe complications including airway obstruction, emergent need for reintubation and death. Its use should be avoided in such procedures. PubMedCrossRef
37.
go back to reference Hillibrand AS, Carlson GC, Palumbo MA, et al. Radiculopahty and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis. J Bone Joint Surg Am. 1999;81:519–28. Hillibrand AS, Carlson GC, Palumbo MA, et al. Radiculopahty and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis. J Bone Joint Surg Am. 1999;81:519–28.
38.
go back to reference ••Burkus JK, Haid RW, Traynelis VC, Mummaneni PV: Long-term clinical and radiographic outcomes of cervical disc replacement with the Prestige Disc: results from a prospective randomized controlled clinical trial. J Neurosurg Spine 2010, 13:208–18. Cevical disc arthroplasty patients in randomized-controlled study with anterior cervical fusion achieved a better neurologic outcome and maintained greater lordosis and angular motion at five year follow-up.CrossRef ••Burkus JK, Haid RW, Traynelis VC, Mummaneni PV: Long-term clinical and radiographic outcomes of cervical disc replacement with the Prestige Disc: results from a prospective randomized controlled clinical trial. J Neurosurg Spine 2010, 13:208–18. Cevical disc arthroplasty patients in randomized-controlled study with anterior cervical fusion achieved a better neurologic outcome and maintained greater lordosis and angular motion at five year follow-up.CrossRef
39.
go back to reference Garrido BJ, Taha TA, Sasso RC. Clinical outcomes of Bryan cervical disc arthroplasty a prospective, randomized, controlled single site trial with 48-month follow-up. J Spinal Disord Tech. 2010;23:367–71.PubMedCrossRef Garrido BJ, Taha TA, Sasso RC. Clinical outcomes of Bryan cervical disc arthroplasty a prospective, randomized, controlled single site trial with 48-month follow-up. J Spinal Disord Tech. 2010;23:367–71.PubMedCrossRef
40.
go back to reference Ryu KS, Park CK, Jun SC, Huh HY. Radiological changes of the operated and adjacent segments following cervical arthroplasty after a minimum 24-month follow-up: comparision between the Bryan and Prodisc-C devices. J Neurosurg Spine. 2010;13:299–307.PubMedCrossRef Ryu KS, Park CK, Jun SC, Huh HY. Radiological changes of the operated and adjacent segments following cervical arthroplasty after a minimum 24-month follow-up: comparision between the Bryan and Prodisc-C devices. J Neurosurg Spine. 2010;13:299–307.PubMedCrossRef
41.
go back to reference ••Jawah A, Cavanaugh DA, Kerr EJ, et al.: Total disc arthroplasty does not affect the incidence of adjacent segment degeneration in cervical spine: results of 93 patients in three prospective randomized clinical trials. Spine J 2011, 10:1043–8. The rate of adjacent level degenerative disease does not appear to differ in patients undergoing cervical disc arthroplasty when compared to anterior cervical fusion in three prospective randomized studeies.CrossRef ••Jawah A, Cavanaugh DA, Kerr EJ, et al.: Total disc arthroplasty does not affect the incidence of adjacent segment degeneration in cervical spine: results of 93 patients in three prospective randomized clinical trials. Spine J 2011, 10:1043–8. The rate of adjacent level degenerative disease does not appear to differ in patients undergoing cervical disc arthroplasty when compared to anterior cervical fusion in three prospective randomized studeies.CrossRef
42.
go back to reference Geck MJ, Eismont FJ. Surgical options for the treatment of cervical spondylotic myelopathy. Orthop Clin North Am. 2002;33:329–48.PubMedCrossRef Geck MJ, Eismont FJ. Surgical options for the treatment of cervical spondylotic myelopathy. Orthop Clin North Am. 2002;33:329–48.PubMedCrossRef
43.
go back to reference Buchowski JM, Anderson PA, Sekhon L, Riew KD. Cervical disc arthroplasty for the treatment of myelopathy. Surgical technique. J Bone Joint Surg Am. 2009;91S:223–32.CrossRef Buchowski JM, Anderson PA, Sekhon L, Riew KD. Cervical disc arthroplasty for the treatment of myelopathy. Surgical technique. J Bone Joint Surg Am. 2009;91S:223–32.CrossRef
44.
go back to reference Anderson PA, Matz PG, Groff MW, et al. Laminectomy and fusion for the treatment of cervical degenerative myeolpathy. J Neurosurg Spine. 2009;11:150–6.PubMedCrossRef Anderson PA, Matz PG, Groff MW, et al. Laminectomy and fusion for the treatment of cervical degenerative myeolpathy. J Neurosurg Spine. 2009;11:150–6.PubMedCrossRef
45.
go back to reference Hirai T, Okawa A, Arai Y, et al.: Middle-term results of a prospective comparative study of anterior decompression and fusion and posterior decompression with laminoplasty for the treatment of cervical myelopathy. Spine 2011, In press. Hirai T, Okawa A, Arai Y, et al.: Middle-term results of a prospective comparative study of anterior decompression and fusion and posterior decompression with laminoplasty for the treatment of cervical myelopathy. Spine 2011, In press.
46.
go back to reference Sakaura H, Hosono N, Mukai Y, et al.: Medium-term outcomes of C3-6 laminoplasty for cervical myelopathy: a prospective study with a minimum 5-year follow up. Eur Spine J. 2011;20:928–33. Sakaura H, Hosono N, Mukai Y, et al.: Medium-term outcomes of C3-6 laminoplasty for cervical myelopathy: a prospective study with a minimum 5-year follow up. Eur Spine J. 2011;20:928–33.
Metadata
Title
Cervical spine: degenerative conditions
Author
Andrew G. Todd
Publication date
01-12-2011
Publisher
Current Science Inc.
Published in
Current Reviews in Musculoskeletal Medicine / Issue 4/2011
Electronic ISSN: 1935-9748
DOI
https://doi.org/10.1007/s12178-011-9099-2

Other articles of this Issue 4/2011

Current Reviews in Musculoskeletal Medicine 4/2011 Go to the issue

Modern Techniques in Shoulder Surgery (Lawrence V. Gulotta, Section Editor)

Reverse shoulder arthroplasty

Modern Techniques in Shoulder Surgery (Lawrence V. Gulotta, Section Editor)

Anterior shoulder instability: a review of pathoanatomy, diagnosis and treatment

Modern Techniques in Shoulder Surgery (Lawrence V. Gulotta, Section Editor)

Proximal humeral fractures

Modern Techniques in Shoulder Surgery (Lawrence V. Gulotta, Section Editor)

Biologic augmentation of rotator cuff repair

Spine (Matthew E. Cunningham, Section Editor)

Adult spine deformity

Modern Techniques in Shoulder Surgery (Lawrence V. Gulotta, Section Editor)

The glenoid in total shoulder arthroplasty