Degenerative cervical spine disease

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• Treatment of Cervical Spondylosis With Dysphagia Caused by Anterior Osteophytes: A Retrospective Case Series Study
• Traumatic central cord Syndrome: An integrated neurosurgical and neurocritical care perspective
• Clinical Indicators of Surgical Outcomes in Degenerative Cervical Myelopathy Assessed Using the JOACMEQ: A Prospective Multicenter Study
• Advancements in Machine Learning for Precision Diagnostics and Surgical Interventions in Interconnected Musculoskeletal and Visual Systems
• Assessing Surgical Outcomes in Cervical Degenerative Disease: The Role of Intraoperative Neurophysiological Monitoring
• Spinal Anesthesia Results in Lower Costs Compared to General Anesthesia for Patients Undergoing Lumbar Fusion-A Matched Cohort Study

see Degenerative cervical myelopathy.

Degenerative cervical spine disease refers to the progressive deterioration of the structures in the cervical spine, including intervertebral discs, facet joints, ligaments, and vertebral body. It is a common condition associated with aging, but it can also be influenced by genetic factors, lifestyle, and mechanical stress.

Degeneration begins with the loss of hydration and elasticity in the intervertebral discs, leading to decreased disc height, annular tears, and disc bulging. This can result in:

- Disc herniation → Compression of nerve roots or spinal cord (radiculopathy or myelopathy).

- Facet joint arthropathy → Hypertrophy, osteophyte formation, and reduced range of motion.

- Ligamentous changes → Thickening of the ligamentum flavum, contributing to spinal stenosis.

- Spondylotic changes → Osteophytes and endplate sclerosis can cause foraminal or central stenosis.

1. Cervical Spondylosis (General degeneration)

1. Neck pain and stiffness
2. Reduced range of motion
3. Occasional headaches (occipital neuralgia)

2. Cervical Radiculopathy (Nerve root compression)

1. Unilateral neck pain radiating to the upper limb
2. Numbness, tingling, and weakness in a dermatomal distribution
3. Positive Spurling’s test

3. Cervical Myelopathy (Spinal cord compression)

1. Gait disturbances (spasticity, imbalance)
2. Upper limb weakness, clumsiness (difficulty with fine motor skills)
3. Hyperreflexia, positive Hoffman’s sign, Babinski sign
4. Urinary urgency or incontinence (in severe cases)

- Clinical evaluation

1. Neurological examination to assess motor, sensory, and reflex abnormalities.

- Imaging

1. Cervical Spine Radiography: Loss of disc height, osteophytes, kyphotic deformity.
2. Cervical Spine Magnetic Resonance Imaging (Gold standard): Shows spinal cord compression, disc herniation, and soft tissue pathology.
3. Cervical spine computed tomography: Useful for bony abnormalities, particularly foraminal stenosis.
4. Electromyography (EMG)/Nerve conduction studies: Helps differentiate radiculopathy from peripheral neuropathy.

Degenerative cervical spine disease treatment

- Many patients with cervical spondylosis remain asymptomatic. - Cervical radiculopathy often resolves with conservative treatment. - Cervical myelopathy is usually progressive and may require surgical decompression for functional preservation.