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 As
a result of the natural wear and tear that occurs
with aging, certain parts of the cervical spine
start to degenerate and wear out, as we grow older.
This process makes some of the anatomic structures
of the cervical spine, the bones, intervertebral
discs, ligaments, and muscles less flexible and
less resistant to injury.
Degenerative
disc disease (DDD) is part of the natural process
of growing older. Unfortunately, as we age, our
intervertebral discs lose their flexibility, elasticity,
and shock absorbing characteristics. The ligaments
that surround the disc, called the annulus fibrosis,
become brittle and they are more easily torn.
At the same time, the soft gel-like center of
the disc, called the nucleus pulposus, starts
to dry out and shrink. Degenerative disc disease
is as certain as death and taxes, and to a certain
degree this process happens to everyone. However,
not everyone who has degenerative changes in their
cervical spine has pain. Many people who have
"normal" necks have MRI's that show disc herniations,
degenerative changes, and narrowed spinal canals.
Every patient is different, and it is important
to realise that not everyone develops symptoms
as a result of degenerative disc disease.
There are soft-tissue
discs between the bony vertebral bodies in your
cervical spine that are called intervertebral
discs. These discs are composed of a soft gel-like
center called the nucleus pulposus, and a tough
outer lining that surrounds the disc called the
annulus fibrosis. The intervertebral disc creates
a joint between each of the vertebral bodies that
allows them to flex and extend, rotate slightly,
and move with respect to one another. When the
outer lining that surrounds the disc tears, the
soft center squeezes out through the opening,
creating a "herniated", "slipped", or "ruptured
disc". Each of these terms describes the same
process.
Myelopathy is a term
that means that there is something wrong with
the spinal cord itself. This is usually a later
stage of cervical spine disease, and is often
first detected as difficulty walking due to generalised
weakness or problems with balance and coordination.
This type of process occurs most commonly in the
elderly, who can have many reasons for having
trouble walking or problems with gait and balance.
However, one of the more worrisome reasons that
these symptoms are occurring is that bone spurs
and other degenerative changes in the cervical
spine are squeezing the spinal cord. Myelopathy
affects the entire spinal cord, and is very different
from isolated points of pressure on the individual
nerve roots.
Doctors use
the term radiculopathy to specifically describe
pain, and other symptoms like numbness, tingling,
and weakness in your arms or legs that are caused
by a problem with your nerve roots. The nerve
roots are branches of the spinal cord that carry
signals out the rest of the body at each level
along the spine. This term comes from a combination
of the Latin word radix, which means the roots
of a tree, and the Latin word pathos, which means
a disease. This disease is often caused by direct
pressure from a herniated disc or degenerative
changes in the cervical spine that cause irritation
and inflammation of the nerve roots.
Cervical spondylolysis
is a disorder that narrows the spinal canal in
the neck compressing the spinal cord or spinal
nerve roots. It's a fracture or defect in the
pars anticulars (a portion of the bone between
each of the joints of the back), allowing one
vertebral body to slide forward on the next. Spondylolyosis
is sometimes referred to as pars interarticularis
defect. It may be unilateral or bilateral and
is usually due to a developmental defect but may
be secondary to a fracture. Spondylolysis affects
the area of the vertebra called the pedicle. The
pedicle is part of the bony ring that protects
the spinal nerves, and is the portion that connects
the vertebral body to the facet joints. It's a
disease that often times affects middle-aged and
older adults who have degenerative discs and vertebrae
in their neck. When a spondylolysis is present,
the back part of the vertebra and the facet joints
simply are not connected to the body, except by
soft tissue.
Stenosis is a term
used to describe a narrowing of various parts
of the body. Cervical stenosis is a degenerative
disease where the spinal canal and neural foramina
narrow and compress the spinal cord and nerve
roots. Stenosis occurs when pressure increases,
inflaming the facet joints. The facet joints are
overlapping arches that form the spinal canal.
These joints are covered with cartilage and a
membrane. Degenerative changes and wear and tear
can cause the facet joints to inflame. This disorder
is most common in people over 50 years of age.
However, genetics and congenital factors may predispose
a person for stenosis.
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