CERVICAL ARTHRITIS

Person's testimonial:

"I was working and I was having a lot of muscular pain in the muscles that extended from my neck. And so finally, I started going in to have therapy, to try and take care of the problem. There are a lot of knots and I was really tense. I thought it was just tension from work."

Cervical arthritis also known as cervical spondylosis is an arthritic condition affecting the upper spine. The vertebrae in the neck known anatomically as the cervical vertebrae begin to degenerate accompanied by degeneration in he flexible discs of shock absorbing cartilage that fit between them.

These changes gradually narrow the space in the vertebrae called the foramen. The hollow part of the vertebrae through which the spinal chord, nerve tissues traverse from the brain. This narrowing causes compression on the nerves leading from the spinal chord in the neck.

The nerves become inflamed producing pain in the neck that may radiate to the arms. Cervical arthritis tends to begin between the ages of 30 and 50 as part of the normal aging process.

Like all arthritic conditions, it may grow worse overtime. Nearly everyone over the age of 50 experiences some wear and tear on the cervical spine. But not everyone develop symptoms of cervical arthritis. Once the cervical vertebrae and their discs begin to degenerate, a minor injury to the spine such as that caused by a fall or sudden twist may provoke symptoms.

This condition may also begin earlier in life, perhaps as the result of a back injury, such as those experienced while playing sports. While cervical arthritis tends to affect men more often than women, its symptoms maybe similar to those produced by two conditions seen more frequently in women.

Rheumatoid arthritis, a disorder affecting the fluid in the joints; and osteoporosis in which many of the bones in the skeleton are weakened. Let's take a moment to look at the anatomy of the spine.

The spine or backbone is a multi-articulated structure that helps determine the health of the entire body. Without it, we cannot run, walk, or curl into sleep. The arms, legs, chest, and head are all attached to the spine which is affected by every move we make.

Because the human spine is held in a vertical position supported by two legs, we place enormous pressure on our spines. The spinal chord, a cylinder of nerve tissue made up of 31 pairs of spinal nerves originating in the brain runs through bones called vertebrae, two points of exit between each vertebra. There are 33 spool shaped vertebrae. This irregular round structures stack on top of each other most separated by a ring of shock absorbing cartilage and discs of fibrous tissue with a soft gelatinous core.

The upper 24 vertebrae are joined like links in a chain while the lower nine are fused together into two groups forming the sacrum and coccyx. The vertebrae of the lower back make up what is know as the lumbar region. Above that are the thoracic vertebrae with the cervical vertebrae in the neck region.

Ligaments and muscles stabilize the spine and attached to bony processes or joints connecting the spine to the ribs and other bones. The vertebral column begins at the skull and anchors in the pelvis where it transmits the weight of the upper body to the lower limbs. Because of its position at the center of the body, functioning as a message pathway for nerves and a flexible link to other parts of the skeleton, the health of the spine affects every feature of our wellbeing.

Person's testimonial:

"I though that I had a pinched nerve. So that's what--because it's--I'm having numbness in my hand and I could feel that it was going through the nerve in my elbow."

Symptoms of cervical arthritis may include chronic neck pain particularly with motion, muscle weakness with numbness in the neck and arms perhaps also the hands and fingers, tenderness to the tough at the neck itself, stiffness which limits movement of the neck, headaches, and lost of balance.

Degeneration of the cervical vertebrae can produce several different conditions affecting the spinal chord and nerve roots. Boney ridges called osteophytes often develop on the vertebrae as a result of arthritic change reducing space for the spinal chord and limiting movement of the neck. The facets of the vertebrae, those potions that interlock with each other may also show wear and tear.

Occasionally, one of the soft discs cushioning the vertebrae may rupture resulting in a herniated disc. When this happens, there is usually pressure against the spinal chord or nerve roots. Also a herniated disc is a distinct problem, however, usually occurring as a single instance whereas cervical arthritis is a progressive chronic process. Cervical disc hernias usually result in prominent arm and hand pain rather than neck pain.

If the patient experiences chronic neck pain, the physician may use a number of different tests to determine whether the condition is cervical arthritis. X-ray shows any abnormalities in the bones of the spine and helps determine the amount of degeneration in the vertebrae and their facets.

A myelogram or dye test with computer tomography scan provides the best detail of the bone structure of the spine. MRI, magnetic resonance imaging scans are sometimes done to get a clearer picture of other structures in the spine besides bone.

Person's testimonial:

"He explained the whole thing to me. He was very good. And basically, I think when you're in that much pain, you just have to trust that everything is gonna go alright because you know you cannot continue to be in this much pain."

Most cases of cervical arthritis respond to conservative treatment that is carefully thought out for each individual. Rest of the neck area is essential. To accomplish this, it maybe necessary to consider your general posture, the kinds of pillows you use in bed, and the features of your occupation that affect the condition of your neck.

Nonsteroidal anti-inflammatory medication such as aspirin, acetaminophen or ibuprofen known as NSAIDs may be recommended to decrease swelling and relieve pain. Sometimes time release medication is most effective. While other pain killers may be prescribed, narcotic pain medication is generally avoided.

Patients who have a severe episode of cervical arthritis may benefit from a single treatment of a steroid epidural injected directly into the affected part of the neck. This form of treatment can often relieve the situation to such a degree that other conservative treatment measures can then be put into place.

Other nonoperative measures may include cold compresses to relieve acute pain. Massaging the muscles is also helpful. And then avoiding stressful conditions may also help. The physician may recommend ultra sound or whirlpool treatments. A physical therapist may be able to help perform gentle neck exercises and will have advice about improving posture in order to minimize the effects of cervical arthritis. Positioning of the neck may improve or worsen neck pain.

When arthritis is the primary cause of the pain, the neck might be made to feel better in a flexed position. If on the other hand, this is the result of a motor vehicle injury or a blow then putting the neck in extension may relieve the pain. Traction is also helpful. A simple method of performing traction is to use the weight of the head as a traction device.

If pain is eased in extension, lying on a bed with the head off the end of the bed will provide 8 pounds of traction inflection. Surgery is generally recommended only in more severe pain or muscle weakness when the condition appears unresponsive to other forms of treatment.

Patients should discuss the possibility of surgery with an experienced surgeon weighing the likelihood of success in each particular case. Surgical procedures are tailored to the severity of the condition.

Over the past 20 years, there has been a significant increase in the use of cervical plates for single and multilevel anterior cervical surgery. Cervical plates offer the advantage of improved initial stability in the postoperative period which decreases the need for wearing a cervical collar and results in a faster return to normal activities. The cervical plate systems a physician uses can also vary depending on surgeon preference and surgical procedure.

Some well known blade systems include the Atlantis and Orion anterior cervical plate systems. While the zephyr and premier anterior cervical plate systems are two fairly new but widely use systems. Whether a surgeon uses a cervical plate during surgery or not, the cervical procedure will vary with whether or not the surgeon will need to remove a portion of bone to relieve pressure on the spinal chord.

Surgery may also be used to fuse some of the cervical vertebrae, remove a damaged disc or enlarge the spinal chord space by clearing at a boney spurs.

Person's testimonial:

"My neurosurgeon got me in to have the surgery in less than a week. I went in and to the hospital it was about 12:30, had the surgery, lasted about 2 hours, went to the recovery, I was put in the hospital for less than 23 hours and then I went home."

As in the case of any surgical procedure, outcomes are dependent on the state of one's general health including mental and emotional health. Surgery should be undertaken when the patient is in the best possible health with any other chronic conditions under effective management.

If surgery is chosen, the patient must be aware of the risks involved. The recovery period required and various limits on activities during that time. Some of the potential risks of surgery include injury to nerves and blood vessels, risks of anesthesia, excessive bleeding, muscle weakness, blood clots and the possibility of infection.

The patient should carefully consider these risks along with the possible advantages of the surgery and wave them carefully. Because the rehabilitation process require so much effort on the part of the patient, it is important that they have a positive attitude. Because of rapid advances in medical technology during the last several decades, cervical arthritis can now be detected much earlier to mainly to improve diagnostic imaging and surgical procedures.

Person's testimonial:

"Now I'm back at work. I work full time. I can do everything that I did before the surgery. And I just--I feel great."

This video is for your general education only. Information in this video cannot replace the relationship that you have with your health care professional. Neither Medtronic Sofamor Danek USA, Inc., its parent, its affiliates, nor DynoMed, Inc., practice medicine or provide medical services or advice as a part of this video, and neither do the people or organizations who provided information for use in this video. You should always talk to your health care professional for diagnosis and treatment.

DynoMed, Inc., as the producer of this videotape, does not practice medicine, does not recommend this or any other surgical technique for use on a specific patient, and does not guarantee the results of any particular surgical technique. Each patient should consult a physician for determining the necessity of surgery, and for the determination and utilization of the appropriate surgical techniques.

©2002 Medtronic Sofamor Danek USA, Inc.
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