Neck pain and stiffness frequently occur in the aging spine. This is due to arthritic changes in the joints and degenerated discs, often revealed through regular x-rays.
Symptoms & Diagnostics
When neck pain is associated with pain and/or numbness or weakness in the shoulder, arm, or hand, further workup may be needed, as these symptoms indicate pressure on the spinal cord or one or more nerve roots. Severe spinal cord pressure in the neck may cause symptoms of arm and leg weakness, imbalance, and problems with the hand use, such as buttoning shirts, and handwriting. Evaluation includes the following diagnostic measures:
- Thorough neurologic examination
- Imaging using an MRI and/or CT scan.
Initial treatment can consist of any of the following:
- Immobilization with a collar
- Non-steroidal anti-inflammatory medications
- Physical therapy
If the symptoms are significant and persistent after nonoperative measures and/or a significant neurological deficit is apparent, surgical treatment is often necessary.
- Anterior cervical discectomy and fusion is most commonly performed for cervical degenerative disc disease and can also include removal of the degenerative bony spurs that occur around the border of the discs. The fusion is performed with either bone from the pelvis (iliac crest) or from the bone bank (donated bone), and the vertebrae are usually fixed together using a metal plate and screws.
- Posterior decompression and stabilization might be performed as an alternative to anterior cervical discectomy, if multiple levels are involved. This procedure uses plates and screws, and may also require a fusion.