Cervical discopathy
Cervical discopathy involves mechanical damage to the intervertebral discs in the cervical section of the spine. It is one of the most common causes of upper back (neck) pain and the so-called brachial neuritis. Discopathy can have many causes, but is most commonly caused by wear and tear due to the accumulation of microtrauma that occurs with age. It usually affects people aged 35-55 years. Discopathy can affect both the cervical and lumbar spine.
We can distinguish between three types of discopathy:
- degeneration of the intervertebral disc without bulging
- degeneration of the intervertebral disc with bulging
- intervertebral disc herniation with damage to ligamentous structures and so-called sequestration, i.e. disc content prolapse into the spinal canal.
The most intense pain is caused by the disc pressing on nearby nerves. Depending on the location of the hernia, the patient may experience neck pain and/or pain radiating to the extremities. Intense and prolonged pressure causes damage to sensory and nerve fibres, resulting in sensory disturbances and even paresis of certain muscle groups.
A typical symptom of discopathy is neck pain. Sometimes other ailments join in:
- pain radiating to the arm / hand
- sensory disturbances in the hand
- weakening of hand muscles, e.g. dropping objects from the hand.
Discopathy is actually a natural ageing process of the spine and relatively rarely results in complaints. In extreme cases it can cause what is known as myelopathy, a compression syndrome of the spinal cord. The typical triad of symptoms in myelopathy includes:
- difficulty in performing precise tasks with the hands, e.g. buttoning up, writing. Patients with myelopathy are, for example, unable to pick up a coin from the table
- walking impairment. Difficulty in descending stairs is characteristic (! more than ascending)
- urinary disturbances in the late phase
Causes of discopathy:
Degenerative changes in the spine occur with the ageing of the body, are genetically determined, and are also influenced by lifestyle and the environment in which we live.
The main factors that aggravate the formation of discopathy:
- spinal overload
- forced body position during work such as working on a computer, driving a vehicle, working on a production line
- repetitive trauma
Age is considered the most important risk factor for discopathy, other factors such as working in a forced and unnatural position, obesity, lack of physical activity, smoking and frequent injuries can significantly accelerate this process.
Diagnostics and diagnosis
The basis for a correct diagnosis is a detailed history taking with the patient regarding the presence of pain symptoms. The key here is to describe the type of pain and when it occurs. On this basis, the neurosurgeon determines the possible causes and selects the appropriate form of treatment. Depending on the duration of the complaints and their nature, the doctor may refer the patient to an NMR examination (magnetic resonance imaging), which is the best examination to show changes in the anatomical structure of the spine.
Treatment methods for cervical discopathy
Cervical discopathy of the spine may be treated conservatively or surgically; the method of treatment is selected on the basis of the size of degenerative changes and the intensity of pain. The aim of conservative treatment is to minimise pain, prevent progression and enhance the body’s natural regenerative processes.
Conservative treatment
The primary form of non-operative treatment is the use of specialist physiotherapy. At the VM hospital, the most common methods used are manual therapy and physiotherapy (including Super Inductive System – SIS). Among the pharmaceuticals, the doctor usually recommends painkillers from the group of non-steroidal anti-inflammatory drugs (NSAIDs), but in case of intense pain, the doctor may recommend stronger painkillers or topical treatment.
Surgical treatment
For prolonged pain or other specific symptoms that do not subside with conservative treatment, the neurosurgeon may recommend surgery. The main aim of surgery is to eliminate the pressure of the disc or degenerative changes on the adjacent nerve structures and to minimise the risk of their damage. The method of surgical treatment is determined by the neurosurgeon individually based on the patient’s condition. At the Vratislavia Medica hospital we try to use minimally invasive techniques, causing as little tissue damage as possible. The basic techniques in cervical discopathy surgery are:
- Posterior cervical foraminotomy
- Anterior cervical foraminotomy with fusion (ACDF)
- Cervical arthroplasty (disc replacement with an artificial disc)
The use of minimally invasive methods has definite advantages for the patient, the interference in the bone and joint system of the spine is minimised. A patient undergoing minimally invasive surgery is verticalized on the first day and discharged home the following day.
Important!
Remember, if you are experiencing pain in the neck or its back radiating to your hand/arm for more than a few days, it is necessary to consult a neurosurgeon who, on the basis of a detailed medical history, physical examination and often also imaging examination, will recommend an appropriate form of treatment for you.
Sometimes the symptoms of discopathy build up over years and patients see a doctor far too late, when the situation is already serious and treatment options are limited.
Available treatment methods:
