Saturday, April 13, 2024

Surgery For Degenerative Disc Disease In Neck

What Are The Symptoms Of Degenerative Disk Disease

Degenerative disc disease surgery: Beths story | Ohio State Medical Center

The most common symptoms of degenerative disk disease are neck pain and back pain. You may experience pain that:

  • Comes and goes, lasting for weeks or months at a time.
  • Leads to numbness or tingling in your arms or legs.
  • Radiates down your buttocks and lower back.
  • Worsens with sitting, bending or lifting.

Symptoms Of Degenerative Disc Disease In The Neck

Degenerative disc disease in the neck can remain asymptomatic in some individuals. In others, the patient may suffer from muscle spasms and tenderness in the cervical spine, pain in the neck, and referred pain and paraesthesia in the arm, chest, head, shoulders, and in the lower body. Acute inflammation can cause flare-ups of symptoms with more pressure put on spinal nerves in an already narrowed cervical spine. As the discs degenerate further the space through which nerves and blood vessels in the cervical spine have to travel is increasingly diminished, making myelopathy a likely outcome. This spinal stenosis and spondylosis can be exacerbated by the growth of osteophytes, and other degenerative changes in the bones, facet joints, and ligaments of the spine.

Disc degeneration leads to stiffness of the neck and back as discs no longer allow the flexibility of movement they did when they were supple and strong. Brittle discs are also more likely to herniate, causing acute pressure in the spine and often resulting in extreme debility and pain. Pain is generally worse at the end of the day, with inflammation and muscle strain building throughout the day for most patients.

What Are The Symptoms Of Cervical Ddd

Most people with cervical DDD are asymptomatic. However, cervical DDD may be associated with a gradual development of symptoms that may further deteriorate with time. Patients may experience pain and other symptoms in their shoulders and arms, this is known as radiculopathy. Some of the common symptoms of cervical DDD include:

  • Mild to intense pain
  • In rare cases, bowel and bladder dysfunction

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A Majority Of Patients With Clearly Defined Mri Abnormalities Who Were Not At All Bothered By Neck Pain

Compounding this is the always present rush to surgery spurred on by MRI. Doctors at Yale University suggested to doctors not to solely rely on MRI readings when evaluating patients for neck pain treatment: Physicians should be aware of inconsistencies inherent in the interpretation of cervical MRI findings and should be aware that some findings demonstrate lower agreement than others . This agrees with the first study showing a majority of patients with clearly defined MRI abnormalities who were not at all bothered by neck pain.

V Definition Of Terms

Color X
  • Cervical degenerative disc disease: age-related changes in the cervical spine that may result in pain, radiculopathy, and/or myelopathy
  • Cervical disc arthroplasty: cervical artificial disc replacement
  • Cervical hybrid surgery: use of anterior cervical fusion and anterior disc replacement at different spinal levels in patients with multi-level cervical disc disease
  • Corpectomy: removal of vertebral body
  • Discectomy: removal of disc
  • Foraminotomy: surgery to widen the bony area where spinal nerve roots exit the spinal column
  • Fusion: a stabilizing surgery where vertebral levels are fused using a bone graft or other material
  • Kyphotic deformity: an abnormally forward pitch of the spine, often due to compression of vertebrae
  • Laminoplasty: surgical procedure that enlarges the spinal canal by lifting a piece of bone covering the spinal canal
  • Laminotomy: surgical removal of a piece of bone to enlarge the spinal canal
  • Myelopathy: compression of the spinal cord that may result in pain, paresthesias, and reduced functioning
  • Pseudarthrosis: failure of fusion after vertebral fusion surgery
  • Radiculopathy: caused by a compressed nerve root that may result in pain, paresthesias, and reduced functioning

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Basic Treatment For Disc

In most cases, when a patient is diagnosed with degenerative disc disease in the neck, treatment will usually include some combination of conservative techniques. Over the course of several weeks or months, these treatments are designed to relieve pain, improve spinal flexibility and increase spinal stability by strengthening the muscles that support the neck and head. It is important to note, however, that finding the right combination of treatments usually involves some trial and error, so you should have realistic expectations about the process. If a particular technique proves to be ineffective, this isnt necessarily bad news, as it can provide your doctor with additional insight into your condition, allowing for an adjustment to the treatment plan.

Here are a few examples of common conservative treatments:

  • Nonsteroidal anti-inflammatory drugs

Common Surgeries For Cervical Degenerative Disc Disease

The two most common surgeries for cervical degenerative disc disease both involve a discectomy but differ in how they restore that vertebral levelâs disc space to its normal height:

  • Anterior cervical discectomy and fusion . After the discectomy is performed through the front of the neck, a bone graft is implanted in the space where the disc was removed. Hardware, such as a cage or plate, is also installed to hold the adjacent vertebrae in place and help facilitate the bone graft to grow and eventually fuse these two vertebrae into one solid bone. Even though the hardware is no longer needed after the bones have fused together many months later, the hardware is not removed.
  • See Cervical Artificial Disc Replacement Surgery

ACDF is the more common surgery, but ADR is increasingly being performed. In cases where more than one disc needs to be removed, sometimes a hybrid surgery is performed, such as with fusion at one level and then artificial disc replacement at the level immediately above.

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Treatment Options For Dealing With Cervical Degenerative Disc Disease

If you have been diagnosed with cervical degenerative disc disease, you are probably curious about your treatment options. The pain and disability that accompany a degenerated disc can impact daily life, causing chronic pain, numbness and tingling of the arms, and loss of function.

Fortunately, there are a range of treatment options aimed at alleviating pain, reducing symptoms, and restoring function. Let’s start with prevention.

How Ddd Is Diagnosed

Degenerative disc disease surgery: Andrews story | Ohio State Medical Center

Diagnosis is usually arrived at through the use of x-rays, MRI and CT scans. These can highlight structural abnormalities and show spinal stenosis and compression of the vertebra. The use of selective nerve root blocks may assist physicians in isolating the problematic disc prior to treatment, and frequently provide relief from the associated pain after this diagnostic procedure. Treatments may involve gentle, non-invasive spinal decompression using devices for neck pain relief.

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Surgery For Cervical Degenerative Disc Disease

Surgery to treat cervical degenerative disc disease is generally considered in two cases:

  • Neurological symptoms are present, such as persistent arm numbness and/or weakness, or trouble with walking or bowel control. If neurological symptoms are caused by cervical DDD there is a risk of permanent nerve damage, and surgery may be recommended to alleviate pressure on the nerve.
  • Chronic pain is severe and not adequately relieved after at least six months of non-surgical treatments, and daily activities become difficult. Better surgical results are predicted for patients with chronic pain coupled with other findings such as cervical instability, and/or radiculopathy.

The two most common types of surgery for cervical degenerative disc disease are:

  • Anterior cervical discectomy and fusion . This procedure is done through the front of the neck and involves removing the problematic disc, decompression of the nerve root, and insertion of a bone graft or a metal cage device to help maintain or reestablish the normal height of the disc space.

Anterior cervical discectomy and fusion procedure.

For relieving pressure on nerve roots and/or the spinal cord and thus reducing neurological symptoms like arm pain or weakness, neck surgery tends to have a good success ratesome estimates in literature are between 80% and 90%.1

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What Happens During Cervical Disk Replacement Surgery

Just before the procedure starts you will have an intravenous line started so you can receive fluids and medications to make you relaxed and sleepy. This procedure is usually done under general anesthesia . Medication may be given through the IV to put you to sleep and a tube may be inserted in your throat to protect your airway and supplement your breathing. The actual procedure may last a few hours. This is what may happen once the procedure begins:

  • Monitors are placed to check your heart, blood pressure, and oxygen level.

  • The area of your neck where the incision will be made is cleaned with a special solution to kill germs on the skin.

  • A one- to two-inch incision is made on the side or front of your neck.

  • The important structures of the neck are carefully moved to the side until the surgeon can see the bones of the vertebrae and the cervical disk.

  • The cervical disk that is being replaced is removed.

  • The artificial disk is secured into the empty disk space.

  • The incision is closed using absorbable sutures under the skin. The skin is then carefully closed with sutures that minimize any scarring.

  • A small dressing is applied over the incision, a rigid or soft neck collar may be put on your neck to restrict motion, and you will be taken to the recovery area.

  • Some steps might be slightly different from those outlined above. Talk with your health care provider about what might happen during your procedure.

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    Surgical Options For Cervical Degenerative Disc Disease

    When cervical degenerative disc disease progresses, more than just the discs are affected. As the disc loses hydration and starts to collapse, it has a reduced ability to handle axial loads and cushion the vertebrae. Other joints become more stressed and can experience degeneration, such as the uncovertebral joints located on the sides of the vertebrae, and the facet joints located at the back of the vertebrae. Other nearby structures, including ligaments, can also experience more inflammation and degeneration.

    Anterior cervical discectomy and fusion is the procedure more commonly used to treat cervical degenerative disc disease. Watch:Anterior Cervical Discectomy and Fusion Video

    Various surgical options are available for treating symptoms of cervical degenerative disc disease. The choice typically comes down to which vertebral level are affected, as well as the specific location within the vertebral level that are causing compression of a nerve root and/or the spinal cord.

    Symptoms Of Degenerative Disc Disease

    Lumbar Degenerative Disc Disease

    Back and neck pain are the most common symptoms of degenerative disc disease. The severity of the pain associated with the condition varies from person to person. Where the pain is will depend on where the affected disc is located.

    Symptoms of lumbar degenerative disc disease include:

    • Low-grade, continuous pain in the back, buttock or leg
    • Pain that worsens with movements, such as bending over or twisting
    • Pain that worsens when sitting
    • Prolonged standing
    • Numbness, weakness or tingling in the legs
    • Trouble with coordination and balance
    • Loss or bladder or bowel control

    Symptoms of cervical degenerative disc disease include:

    • Pain in the neck or arm
    • Numbness or weakness that is radiated down through the shoulder to the arm and hand
    • Difficulty moving the arms

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    Observation Rush To Surgery Not Endorsed By Researchers

    Doctors at the Rothman Institute, Thomas Jefferson University and Hospitals found: With many surgeons expanding their indications for cervical spine surgery, the number of patients being treated operatively has increased. Unfortunately, the number of patients requiring revision procedures is also increasing, but very little literature exists reviewing changes in the indications or operative planning for revision reconstruction.

    What these researchers are saying in their study is that doctors have broadened the criteria for neck surgery so more can be justified. However, the literature is not keeping up with ways to help the increasing new group of failed neck surgery patients.

    Risk Factors For Degenerative Disc Disease

    • Weight extra weight can add pressure to the back and put you at higher risk for degenerative disc disease.
    • Smokers smoking can break down the bones and discs and put you at higher risk for degenerative disc disease.
    • Occupation people who must lift heavy objects for their careers are at higher risk for degenerative disc disease.
    • Repetitive activities people who do repetitive activities, like weight lifters, are at higher risk for degenerative disc disease.

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    Ii Systematic Review By The Section On Disorders Of The Spine And Peripheral Nerves Of The American Association Of Neurological Surgeons/congress Of Neurological Surgeons

    The evidence was classified into three levels.4) Briefly, Class I evidence evolved from well-designed randomized controlled trials , Class II evidence arose from RCTs with design problems or from well-designed cohort studies, and Class III evidence arose from case series or poorly designed cohort studies.

    For the treatment of cervical spondylotic myelopathy, widely utilized techniques including ACDF, ACCF, laminoplasty, and laminectomy with fusion improved functional outcome .5) ACDF and ACCF exhibited similar results in multilevel spine decompression for lesions at the disc level . Without anterior plating, ACCF provided a higher fusion rate and a higher graft failure rate than multilevel ACDF . Laminectomy was associated with late deterioration compared to other types of anterior and posterior surgeries . Patients with mild spondylotic myelopathy responded to surgical decompression or nonoperative therapy .6) More severe myelopathic patients responded to surgical decompression and the effects of the surgery were maintained for 515 years .

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    Lumbar Degenerative Disc Disease : Part 3: Surgical Treatments, The “Tiger Woods” Surgery.

    Did you know you can support education and research for treatments like artificial cervical disc surgery while you shop, at no extra cost to you?Register with to designate the NREF as your charity, and a percentage of your purchase is donated automatically.

    • Allergic reaction to the implant materials
    • Bleeding may require a blood transfusion
    • Blood vessel problems other than bleeding
    • Development or progression of disease at other cervical levels
    • Implants that bend, break, loosen or move
    • Incision problems
    • Loss of motion at the treated cervical level
    • Numbness or tingling in the extremities
    • Pain or discomfort
    • Spinal cord or nerve damage
    • Spinal fluid leakage

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    A Surgical Solution For Degenerative Disease In The Neck

    Back Pain, Head and Neck Surgery

    Tiny structures in your neck can create big problems elsewhere in your body. Cervical osteoarthritis, characterized by the deterioration of the bones and cartilage in the neck, can cause radiating pain in the arms and legs, numbness, difficulty walking, lack of coordination and even incontinence.

    And its not rareabout 1 in 5 people older than 65 deal with symptoms from arthritis in the neck, says Deb Bhowmick, MD, a neurosurgeon specializing in complex spinal surgery at UNC Medical Center.

    Fortunately, UNC Health Care offers a procedure to help alleviate these symptoms: total disc arthroplasty, or TDA.

    Surgery For Degenerative Disc Disease

    If back or neck pain caused by degenerative disc disease doesnt respond to medication or therapeutic injections, NYU Langone doctors may recommend a surgical procedure. Surgeons may remove some or all of a damaged disc, take pressure off a pinched nerve, or eliminate movement between the bones of the spine.

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    Is Degenerative Disc Disease Surgery Right For Me

    Degenerative disc disease may progress to the point where surgery is your best chance for increased mobility. If you have been receiving treatment with no success, surgery might be the next step. Consult the spine surgeons at Arkansas Surgical Hospital to decide if surgery is right for you.

    The surgeons at Arkansas Surgical Hospital have performed hundreds of surgeries for degenerative disc disease to help patients seek pain relief and return to normal function. Our specialists will evaluate the severity of your degenerative disc disease to determine if you need surgery. Their evaluations will help them decide on the right approach for treating your spine. Request an appointment online or call 748-8000 to schedule a consultation.

    Lumbar Degenerative Disc Disease

    What is Degenerative Disc Disease ? ICD 10, Symptoms, Causes, Treatment

    Just as the cervical spine stops at the top of the rib cage , the lumbar spine starts at the bottom of the rib cage . The 5 vertebral bones in the lumbar spine, L1 through L5, are much larger than the vertebral bones in the cervical spine. This makes sense when you consider how much more body weight they have to support compared to the spinal bones in the neck. These relatively large lumber vertebrae need hearty and resilient discs to support weight, absorb shock, and provide flexibility. In lumbar degenerative disc disease, one or more of the intervertebral discs in the lumbar spine breaks down and causes symptoms. Lumbar degenerative disc disease most commonly occurs in the disc between L4 and L5 spinal bones but can occur at any place between L1 and S1 .

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    How Surgery Can Help Cervical Degenerative Disc Disease

    As cervical degenerative disc disease progresses, the breakdown of discs and facet joints causes the spine to become less stable. This instability can contribute to a nerve root and/or the spinal cord becoming compressed and symptomatic. As such, the two primary goals of surgery for cervical degenerative disc disease are to:

  • Relieve any nerve compression. If a disc or other structure is pressing against a nerve root or the spinal cord and causing symptoms, any surgery to relieve those symptoms must remove the cause of the compression.
  • Stabilize the spine. After the removal of the disc or other structure causing nerve or spinal cord compression, an instability in the spine must typically be addressed.
  • Two of the more common surgeries to address degenerative discs are anterior cervical discectomy with fusion and artificial disc replacement . These surgeries have relatively high success rates for relieving symptoms related to a compressed nerve root, such as pain, tingling, numbness, and/or weakness that radiates into the arm or hand. However, these surgeries are less likely to relieve neck pain that is unrelated to nerve or spinal cord compression.

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