The pathology underlying the condition known as degenerative cervical disc disease is not well understood. However, as the disc decays, it weakens, and then it begins to herniate into the space occupied by the spinal roots and spinal cord. This produces pain and other symptoms. Surgical discectomy is usually needed to remove the disc, and spinal fusion may be required to stabilize the vertebral bones.
Physiology of the Disease
The reason degenerative disc disease occurs is not known, yet research has shown that a number of factors change as the disc degenerates. According to SpineUniverse, the intervertebral disc is like a fibrous bag with gel inside. This structure acts like a cushion between vertebrae. With degenerative disc disease, the outer fibrous layer forms tears and small defects in its walls. With movement of the adjacent bones, the softer inner portion can protrude through a defect in a process called herniation. The herniated material bulges out of the intervertebral space and onto the spinal nerves or spinal cord.
Risks
The risk of cervical disc degeneration is greater for people under age 40 who repetitively lift heavy objects, experience vibrational stress or participate in high impact sports, according to MDGuidelines. Cigarette smoking, the level of physical activity, nutrition and neck injuries also increase risk.
Incidence and Prevalence
According to MDGuidelines, about 8 percent of herniated intervertebral discs occur in the cervical spine. Among pain-free patients, the herniated discs can be detected by MRI in about 10 percent of those under age 40 and in 5 percent in those older than 40. Displaced intervertebral cervical discs are as prevalent in men as in women. According to the Mayfield Clinic, people in their sixties rarely present with degenerative cervical disc disease.
Symptoms
Symptoms of cervical degenerative disc disease vary depending on the patient's general health. According to the "British Medical Journal," cervical disc disease can result in symptoms of myelopathy, which are characterized by central nervous system damage, and radiculopathy, or those characterized by peripheral nerve damage. According to the journal, pain and sensory dysfunction can occur anywhere from the feet to the head. Horner's syndrome may also develop, as can weakness on only one side of the body. Patients may also have difficulty walking.
Surgery
Surgery is usually performed if conservative measures have failed. Since the diseased disc is the reason for the pain and other symptoms, a discectomy is performed for either partial or complete disc removal. According to MDGuidelines, a discectomy is usually followed by fusion of the vertebrae. This is frequently required since the disc no longer separates the vertebral bones and pathology can occur if there is movement between them.
References
- SpineUniverse: Cervical Degenerative Disc Disease -- Spinal Cord and Nerve Compression
- MDGuidelines: Displacement, Cervical Intervertebral Disc Without Myelopathy
- "British Medical Journal"; Degenerative Cervical Disc Disease Causing Cord Compression; P. Bently, et. al.; February, 2001
- Mayfield Clinic: Degenerative Disc Disease
