Cervical Degenerative Disc Disease - ACDF
Seven vertebrae make up the cervical area of your spine. The back part of the vertebra arches to form the lamina. The lamina creates a roof-like cover over the back of the opening in each vertebra. The opening in the center of each vertebra forms the spinal canal.
Intervertebral discs are located between the vertebrae in the cervical spine. The discs are made up of strong connective tissue. Their tough outer layer is called the annulus fibrosus. Their gel-like center is called the nucleus pulposus. A healthy disc contains about 80% water.
The discs and two small joints connect one vertebra to the next. The discs and joints allow movement and provide stability. The discs also act as a shock-absorbing cushion to protect the cervical vertebrae.
The top section of the cervical spinal canal is very spacious. It allows more room for the spinal cord than any other part of the vertebral column. The extra space helps to prevent pressure on the spinal cord when you move your neck.
Your spinal cord, spinal nerves, and arteries that supply blood travel through the protective cervical spinal canal. The spinal cord segments in the neck are indicated by C1-C8. Nerves exit the spine at different levels. Nerves at this level supply the shoulders, arms, and hands.
With age, the discs lose water content. The discs become narrower and less flexible. An injured disc deteriorates. Without the protective disc, the cervical spine can become structurally unstable and unable to tolerate stress. Painful bone on bone rubbing can result.
Without the protective disc, abnormal bone growths, called spurs or osteophytes, can grow in the joint and spinal canal. The bone spurs add to pain while disrupting movement. The changes in spine structure can cause one vertebra to shift forward and out of place, a condition called spondylolisthesis. Without the disc to act as a cushion, the ligaments and facet joints on the vertebrae may enlarge to help compensate for the stress on the spine. The overgrowth can extend into the spinal canal causing it to narrow. The narrowed spinal canal can compress the spinal cord and nerves, resulting in pain and loss of function. This condition is called spinal stenosis.
Degenerative disc disease can lead to a herniated disc. The outer disc layer, the annulus, can tear or rupture under stress. A herniated disc occurs when the annulus ruptures and the inner contents, the nucleus pulposus, comes out of the disc. When the inner contents come in contact with the spinal nerves, they become irritated and swell, resulting in pain.
_____ Trauma increases the risk of the condition.
_____ Arthritis and the natural aging process increase the risk of degenerative disc disease.
Degenerative disc disease may or may not cause symptoms. You may have pain in the back of your neck. You may experience sudden pain after an injury or your pain may start gradually and increase over time. Your pain may be so intense that it interferes with you daily activities. You may feel burning pain, pressure, numbness, or tingling. The symptoms may spread to your shoulders, arms, and fingertips.
During a myelogram, an injected dye is used to enhance x-ray images. This procedure can indicate if there is pressure on your spinal cord or nerves from herniated discs, bone spurs, or tumors.
MRI scans are very sensitive. They provide the most detailed images of the discs, ligaments, spinal cord, and nerve roots. X-rays, CT scans, and MRI scans are painless procedures.
Following surgery, your doctor will initially restrict your activity level and body positioning. You should avoid lifting, housework, and yard-work until your doctor gives you the okay to do so. Once your neck has healed, physical therapists will teach you flexibility and strengthening exercises. You will also learn proper body mechanics to use when you stand, sit, and lift objects.
The recovery process is different for everyone. It depends on the particulars of your surgery and the extent of your condition. Your surgeon will let you know what to expect. Generally, the recovery time for ACDF is several weeks. Your arm pain should go away fairly quickly however, it may take weeks to months for arm weakness and numbness to resolve.
Ongoing studies are looking at alternatives to traditional fusion, including total disc replacement surgery. Studies of nucleus replacement technologies have shown encouraging results in the treatment of lumbar degenerative disc disease and studies of cervical disc arthroplasty are underway comparing long-term outcomes to more traditional techniques.
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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.
The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.