Neck Degenerative Disc Disease, Radiculitis

General Anatomy of the Spine

Posterior (Back) Spinal Column

The spine or backbone is made up of a series of bones known as “vertebrae”. The spine is divided into 5 major sections:

  1. Cervical spine (neck): contains 7 vertebrae labeled C1 to C7
  2. Thoracic spine (mid-back): contains 12 vertebrae labeled T1-T12
  3. Lumbar spine (low-back): contains 5 vertebrae labeled L1 to L5
  4. Sacrum (part of the pelvis): contains 5 fused sacral vertebrae
  5. Coccyx (tailbone): a triangular bone that makes up the end of the spinal column

The cervical spine vertebrae are smaller in size compared to the other spinal vertebrae. The cervical spine contains 7 vertebrae. The first 2 are specialized, known as the atlas (C1) and axis (C2). The base of the skull sits on the atlas, which connects to the axis and gives the neck the ability to rotate side-to-side and bend forward and backwards (say yes motion).

cervical spine

cervical spine

     Located between each set of spinal vertebrae are small cushions known as “intervertebral discs.” These discs function to prevent bone-on-bone contact between the vertebrae and act as shock-absorbers for stresses placed on the spine.

The vertebrae of the spine surround and protect the spinal cord, which is located within the spinal canal. Connecting to the spinal cord and exiting from between each vertebra are the “spinal nerves.” There are both sensory and motor spinal nerves that carry information between the brain and different parts of the body. Sensory nerves, which exit from the left and right side of each vertebra, connect to various patches of skin and provide us with the sense of touch. Motor nerves also exit on the left and right of each spinal segment and carry signals from our brain to specific muscle groups, allowing movement to occur. 

    vertebrae of the spine   

Conditions Affecting the Neck

  1. DEGENERATIVE DISC DISEASE (DDD):

     DDD, also known as “osteoarthritis” (OA) of the spine, is a condition associated with the natural aging process and describes a general wear-and-tear that occurs over time. DDD is similar to rust formation in the joints and can result due to damage of intervertebral discs, decreased joint cartilage, and/or development of bone spurs.
     DDD can cause decreased joint mobility, spinal instability, and decreased space between vertebrae. With reduced space, some DDD may cause impingement, neck pain, and radiating symptoms (see radiculitus).

osteoarthritis of spine

  1. RADICULITIS:

Radiculitis refers to pain that radiates along the nerves caused by inflammation occurring at the root of its connection to the spinal cord. The pain begins at the injury site and radiates outwards to the extremities. Symptoms of radiculitis can include tingling or the feeling of "pins and needles" in the fingers or hand, weakness in the muscles of the arm, shoulder, or hand, and loss of reflexes.

Radiculitis
 

Common Symptoms

  1. PAIN AND STIFFNESS
  2. MUSCLE SPASM
  3. LOSS IN RANGE OF MOTION
  4. NEUROLOGICAL SYMPTOMS
    • Tingling
    • Numbness
    • Sensory loss
    • Muscle weakness
    • Loss of reflexes
    • Poor balance (severe cases only)

Treatment Options:

Treatment Options

Prognosis

     Degenerative disc disease (DDD), with or without radiculitis are all chronic conditions of the neck. With the exception of surgery, there is no cure because the areas that have developed “rust” cannot be replaced. Therefore, the focus of conservative treatment is to reduce and control current symptoms and prevent further decline. While symptoms may improve (e.g. less pain, better range of motion, less neurological symptoms), depending on the individual and condition severity, recovery may plateau at a certain level.

Prognosis

     Ideally, the level of recovery should be sufficient for day-to-day functioning. However, if the level where one plateaus is not adequate, limitations in daily activities may occur and more invasive treatment (i.e. injection)  may be considered.