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The Cervical Spine



The cervical spine is the portion of your spine which provides structure to your neck. This part of your spine is especially important because it supports your head, allows for significant motion, and protects your cervical spinal cord.

The cervical spine is comprised of the first seven vertebrae (bones) immediately under the base of the head. The vertebrae are the structural components or “building blocks” of the cervical spine. These vertebrae are separated by elastic, shock-absorbing discs. The spinal cord runs through a large central opening (spinal canal) formed by the vertebrae. Nerves branching from the spinal cord exit the spinal canal through small holes (foramen) directly adjacent to the discs and travel to your arms and other parts of your body.

The discs in your neck are made up of a tough outer “annulus” and a gelatinous “nucleus”. In many ways the structure of a disc may resemble the structure of a “jelly roll”. The nucleus is the well-hydrated, jelly-like, inner portion of the disc, which does the majority of the shock absorbing and is contained by the surrounding annulus (the bread portion of the jelly roll). As you age, the nucleus tends to lose water and the annulus may develop cracks. This process, as we will see, may cause problems as one gets older.

As you grow older the discs in your neck (and in your low back) slowly begin to wear out. This is typically a slow, gradual process that begins at a young age and progresses throughout your lifetime. It is important to understand that this process is not a disease or a disorder, but should be thought of as a “function of use” much like shock absorbers on a car become less shock absorbent as more miles are put on the car. Though this process occurs to everybody, it occurs at different rates in different people. Perhaps the most important factor influencing the rate of disc degeneration is genetics. However, other factors such as smoking history, trauma, work history and exposure to repetitive vibrational stresses (driving a truck, operating a jackhammer) may also play a significant role in accelerating this process.

As discs wear out, they tend to lose fluid and become less elastic. As a result, your cervical spine may become stiffer with time. Also, discs tend to lose height as they become less elastic. Much like a marshmallow which is compressed from the top and the bottom, discs often tend to “bulge” around the periphery once they become compressed. This gradual collapse and “bulging” is often at the root of disorders of the cervical spine, which may require surgical intervention.

Because the spinal cord is immediately adjacent to the vertebrae and the back part of the discs, as the discs bulge they may gradually begin to compress the spinal cord. This is a process that when symptomatic, usually requires surgical intervention. More often, the bulging disc or adjacent bone spurs may compress the nerves that exit the spinal canal directly adjacent to the discs. This typically results in neck pain, arm pain and/or arm weakness.

Your Problem Spine

A “herniated disc” may occur when the annulus of the disc may develop a crack, which allows the inner nucleus to slip out through the crack (herniate) and compress the adjacent nerves. This may or may not be related to a specific activity that caused the disc to herniate. This may result on neck pain or pain or weakness in the arms.

Degenerative disc disease a common term used to describe age-related disc degeneration. This term, in fact, is a misnomer. As discussed above, this is not a disease, but a “function of aging.” In this process as the discs lose fluid, they collapse. As the discs collapse, they may bulge around the periphery, which may compress the adjacent nerves or spinal cord. Also, as the discs lose height, the adjacent vertebrae begin to touch and the nerves that exit through the foramen may be further pinched from the top and the bottom. Finally, over time, bone spurs may form adjacent to the bulging discs, which may further irritate the nerves.

Stenosis may be the end result of the gradual degenerative process of the cervical spine. As the discs collapse further, bone spurs may grow into the foramen and the spinal canal, compromising the space available for the spinal cord and exiting nerves. As the nerves and spinal cord become irritated, this may result in pain, weakness, numbness, and loss of coordination.


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