Degenerative cervical spine disease treatment [Neurosurgery Wiki]

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====== Degenerative cervical spine disease treatment ======


==== Conservative Treatment (For mild to moderate cases) ====

- **[[Physical therapy]]**: Strengthening and range-of-motion exercises.
- **[[Medication]]s**:
  - [[NSAID]]s (for pain and inflammation)
  - [[Muscle relaxant]]s (for spasm-related pain)
  - Neuropathic pain agents (gabapentinoids, TCAs)
  - 
- **Lifestyle modifications**:
  - Postural correction, ergonomic adjustments.
  - Avoiding prolonged neck flexion/extension.

- **[[Cervical collar]]** (short-term use in acute pain flares)

- **Epidural steroid injections** (for radicular pain)

==== Surgical Treatment  ====

(Indicated for severe myelopathy or [[refractory radiculopathy]])

1. **Anterior approaches**:
   - **Anterior cervical discectomy and fusion (ACDF)** (most common)
   - **Cervical disc replacement** (motion-preserving alternative)
2. **Posterior approaches**:
   - **Laminectomy with or without fusion** (for multilevel stenosis)
   - **Laminoplasty** (for central canal stenosis without instability)
3. **Foraminotomy** (for foraminal stenosis)