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Cervical Spine

By - Dr. Amitabh Gupta , HOD Neurosurgery , Batra Hospital, New Delhi

The cervical spine (neck region) consists of seven bones (C1-C7 vertebrae), which are separated from one another by intervertebral discs. These discs allow the spine to move freely and act as shock absorbers during activity.
Attached to the back of each vertebral body is an arch of bone that forms a continuous hollow longitudinal space, which runs the whole length of your back. This space, called the spinal canal, is the area through which the spinal cord and nerve bundles pass.
At each vertebral level, a pair of spinal nerves exit through small openings called foramina (one to the left and one to the right). These nerves serve the muscles, skin and tissues of the body and thus provide sensation and movement to all parts of the body. The delicate spinal cord and nerves are further supported by strong muscles and ligaments that are attached to the vertebrae.
Cervical disc disease
Neck pain may be caused by disc degeneration, narrowing of the spinal canal, arthritis, and, in rare cases, cancer or meningitis. For serious neck problems, a primary care physician and often a specialist, such as a neurosurgeon, should be consulted to make an accurate diagnosis and prescribe treatment.
You should consult a neurosurgeon for neck pain if:
·    It occurs after an injury or blow to the head
·    Fever or headache accompanies the neck pain
·    Stiff neck prevents you from touching your chin to your chest
·    Pain shoots down one arm
Cervical stenosis
Cervical stenosis occurs when the spinal canal narrows and compresses the spinal cord and is most frequently caused by aging. The discs in the spine that separate and cushion vertebrae may dry out. As a result, the space between the vertebrae shrinks, and the discs lose their ability to act as shock absorbers. At the same time, the bones and ligaments that make up the spine become less pliable and thicken. These changes result in a narrowing of the spinal canal. In addition, the degenerative changes associated with cervical stenosis can affect the vertebrae by contributing to the growth of bone spurs that compress the nerve roots. Mild stenosis can be treated conservatively for extended periods of time as long as the symptoms are restricted to neck pain. Severe stenosis requires referral to a neurosurgeon.
Symptoms
·    Neck or arm pain
·    Numbness and weakness in both hands
·    Unsteady gait when walking
·    Muscle spasms in the legs
·    Loss of coordination
Treatment
Nonsurgical treatment is the first approach in patients with common neck pain not involving trauma. For example, many patients with cervical disc herniation improve with conservative treatment and time and do not require surgery. Conservative treatment includes pain medication, bed rest, reduction of physical activity, and physical therapy. Your doctor may prescribe medications to reduce the pain or inflammation and muscle relaxants to allow time for healing to occur. An injection of corticosteroids may be used to temporarily relieve pain.

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