CERVICAL SPINE DISEASES

CERVICAL SPINE DISEASES

The cervical spine begins at the base of the skull. Seven vertebrae make up the cervical spine with eight pairs of cervical nerves.

The individual cervical vertebrae are abbreviated C1, C2, C3, C4, C5, C6 and C7.

The cervical nerves are also abbreviated; C1 through C8.

CERVICAL VERTEBRAE & SUPPORTING STRUCTURES

The cervical bones - the vertebrae - are smaller in size when compared to other spinal vertebrae. The purpose of the cervical spine is to contain and protect the spinal cord, support the skull, and enable diverse head movement (e.g., rotate side to side, bend forward and backward).

A complex system of ligaments, tendons, and muscles help to support and stabilize the cervical spine.

Ligaments work to prevent excessive movement that could result in serious injury.

Muscles also help to provide spinal balance and stability, and enable movement. Muscles contract and relax in response to nerve impulses originating in the brain. Some muscles work in pairs or as antagonists. This means when a muscle contracts, the opposing muscle relaxes.

There are different types of muscle: forward flexors, lateral flexors, rotators, and extensors.

SPINAL CORD & CERVICAL NERVE ROOTS

Nerve impulses travel to and from the brain through the spinal cord to a specific location by way of the peripheral nervous system (PNS). The PNS is the complex system of nerves that branch off from the spinal nerve roots. These nerves travel outside of the spinal canal or spinal cord into the organs, arms, legs, fingers - throughout the entire body.

Injury or mild trauma to the cervical spine can cause a serious or life-threatening medical emergency (e.g. spinal cord injury or SCI, fracture).

Pain, numbness, weakness, and tingling are symptoms that may develop when one or more spinal nerves are injured, irritated, or stretched.

The cervical nerves control many bodily functions and sensory activities.

C1       :           Head and neck

C2       :           Head and neck

C3       :           Diaphragm

C4       :           Upper body muscles (e.g. Deltoids, Biceps)

C5       :           Wrist extensors

C6       :           Wrist extensors

C7       :           Triceps

C8       :           Hands

CERVICAL SPINE DISORDER

SYMPTOMS

• Pain

• Weakness

• Numbness

PAIN

Neck pain and symptoms caused by a cervical (neck) spine disorder are a very common.

The cervical spine is composed of many different anatomic structures, including muscles, bones, ligaments, and joints. Each of these structures has nerve endings that can detect painful problems when they occur.

The different parts of the cervical spine are normally well balanced and able to handle all of the movements, stresses, and strains of the body gracefully. However, when the different parts of the cervical spine are injured or start to wear out, your neck can be a significant source of pain and discomfort.

Studies show that approximately fifty percent of the population has evidence of degenerative changes in their cervical spine by the age of fifty. These changes happen because the discs that act as shock absorbers between the vertebral bodies of the cervical spine wear out as we grow older.

As the intervertebral discs wear out, they begin to collapse, or herniate, and become less flexible. The common causes of neck pain and cervical disorders include arthritis, injuries, and trauma. In some situations neck pain can also be a warning sign of something more serious such as spinal cord compression, a tumor or spinal infection.

Any patient suffering from neck, shoulder, head or arm pain should be examined by a doctor in order to determine where the pain originates and what is causing the pain. The tissues involved in producing the pain must also be identified, and how they are being irritated must also be understood.

The history of the pain and any activities that may have triggered it are also important factors in diagnosis and treatment. Impairment of movement in any part of the cervical spine can be responsible for pain, discomfort, and disability.

Accurate evaluation of pain in the neck, shoulder, arm, or head requires knowledge of functional anatomy. If you are suffering from neck pain or pain you believe may be caused by a cervical spine disorder you should seek the medical advice of a physician.

NUMBNESS

Numbness is a very common and significant symptom of a cervical disorder. However, it is a poorly understood and difficult to describe symptom.  

Numbness is usually caused by what is commonly called a "pinched nerve."

A nerve can get "pinched" or blocked by a number of cervical disorders. This blocking of the nerve causes the flow of nutrients to the nerve's membrane to slow down. This slow down can eventually cause the membrane to lose its ability to transmit tiny electrical charges and the nerve fiber may eventually die.

When enough nerves stop working, the skin may feel numbness or a muscle supplied by the nerve may not be able to function normally.

A common cause for numbness in the arms or legs, associated with back or neck pain, is a herniated disc that "pinches" a nerve where it exits the spinal column. When the outer lining (annulus) of a disc "tears," its center (the nucleus) may rupture and press a spinal nerve(s) against the bony surface of a vertebra.

Another cause of numbness is degenerative disc disease. DDD can cause bone spurs to form around the nerve roots. This usually occurs inside the foramen - the opening in the cervical spine where the nerve root leaves the spine to travel into the arm.

If these bone spurs get large enough, they may begin to rub on the nerve root causing irritation. This causes the same symptoms as a herniated disc.

The irritation causes: pain to run down the arm, numbness to occur in the areas to which the nerve provides sensation, and weakness in the muscles that the nerve supplies.

Spinal stenosis, or the narrowing of the spinal canal is another disorder that can cause the symptom of numbness. In the late stages of spinal degeneration, bone spurs and arthritic changes can make the space available for the spinal cord, within the spinal canal, much smaller. The bone spurs may begin to press on the spinal cord or the nerve roots, and that pressure on the nerves in the spinal cord can cause numbness.

WEAKNESS

Weakness is not one of the more common symptoms of a cervical spine disorder, but when it is present it indicates a relatively more severe case of nerve compression and it does require in-depth investigation.

Patients may suffer from an inability to balance their head, weakness in their arm(s), inability to work with arms over the head, grip weakness, dropping things from one or both hands, breaking dishes, or difficulty eating or writing. If several or all of the nerves for one muscle are involved, muscle atrophy can be extreme.

The symptom of weakness can be caused by either pain in the muscles that are trying to move or by damage to the nerve, that supplies the muscle, to the point where it is no longer able to contract.

"Weakness can be assessed in six grades:

A common cause for weakness in the arms associated with neck pain is a herniated disc that "pinches" a nerve where it exits the spinal column. When the outer lining (annulus) of a disc "tears," its center (the nucleus) may rupture and press a spinal nerve(s) against the bony surface of a vertebra.

Another cause of weakness is degenerative disc disease (DDD). DDD can cause bone spurs to form around the nerve roots. This usually occurs inside the foramen - the opening in the cervical spine where the nerve root leaves the spine to travel into the arm. If these bone spurs get large enough, they may begin to rub on the nerve root causing irritation. This causes the same symptoms as a herniated disc.

The irritation causes: pain to run down the arm, weakness to occur in the areas to which the nerve provides sensation, and weakness in the muscles that the nerve supplies.

Spinal stenosis, or the narrowing of the spinal canal is another disorder that can cause the symptom of weakness. In the late stages of spinal degeneration, bone spurs and arthritic changes make the space available for the spinal cord, within the spinal canal, much smaller. The bone spurs may begin to press on the spinal cord or the nerve roots, and that pressure on the nerves in the spinal cord can cause weakness.  

CERVICAL SPINE DISEASES

§  CERVICAL MYO-FASCIAL PAIN

§  CERVICAL SPONDYLOSIS

§  CERVICAL SPRAIN