Neck

The bones that make up your neck are called vertebrae, which are separated by a cushioning gel between them which acts as a shock absorber. As you age, this cushioning diminishes and the nerves between the vertebrae become pinched.  Degenerative arthritis of the spine in the neck (or cervical degenerative disc disease) can pinch nerves that can cause both neck pain and arm pain. Other symptoms include a stiff neck, numbness or weakness in the arm, hand or shoulder. When the disc bulges, it is known as a herniated or slipped disk, which may be caused by injury or trauma to the neck. This is often mistaken for a shoulder injury.
Treatment: Anterior cervical discectomy is an operation performed on the upper spine to relieve pressure on one or more nerve roots, or on the spinal cord. The procedure is explained by the words anterior (front), cervical (neck), and discectomy (cutting out the disk) Just removing the disk and not replacing it or maintaining the space can cause bone collapse and other problems. New materials to replace the disk are the center of today’s research on neck surgery. These new materials are called interbody implants or “cages.” The cage comes in various shapes and heights. It is made of an alloy, called PEEK, which the body does not reject. They are also very durable, in fact, we have a few rugby players that still play competitive rugby with these cages in their necks. Most cages are designed so they can be packed with bone chips or a suitable bone graft substitute. It is important to understand that the cage forms a partial fusion and therefore they do have a lower incidence rate of the other levels failing. Spinal Conditions - Neurosurgeon | Cape Town, South Africa As in the lumbar stenosis the spinal canal can be narrowed in the cervical region. This condition is known as Cervical Spinal Stenosis and is due to the narrowing of the protective spinal canal and the spinal nerve root, caused by degenerative changes or trauma. When this occurs, the spinal nerves become compressed and symptoms of pain, numbness, tingling, heaviness of the leg, electrical shock through the leg at times, arm pain, difficulty walking, stiffness in the legs and deteriorating fine motor skill of the hands can occur. Treatment: Surgery may be done from the anterior ( front) or posterior ( back), and the goal is to take pressure off the spinal cord and spinal nerves. The operation is usually called a decompression or laminectomy. The aim of the operation (decompression) is to open up the spinal canal to create more space for the spinal cord and relieve the painful symptoms associated with Cervical Spinal Stenosis. In some cases a spinal fusion may be done afterwards to ensure the spinal decompression can stabilised and remain in place.
Spinal Conditions - Neurosurgeon | Cape Town, South Africa

Spinal Condition

Neck (Cervical Spine)

Spinal · Neck

The cervical spine (neck) supports and protects the spinal cord as it travels from the brain, and is a common site for degenerative disc disease and nerve compression, particularly with age.

Common Symptoms

  • Neck pain and stiffness
  • Arm pain, numbness or tingling (cervical radiculopathy)
  • Hand weakness or clumsiness, dropping objects
  • Balance problems or an unsteady gait
  • Headaches originating from the neck
  • Weakness affecting the arms and/or legs if the spinal cord is compressed

Causes

Common causes include cervical disc herniation, degenerative disc disease, cervical spondylosis (age-related wear), and spinal stenosis narrowing the space for the spinal cord or nerve roots.

Diagnosis

MRI is the primary tool for assessing cervical discs, nerves and the spinal cord; X-rays (including flexion-extension views) and CT help assess alignment, bone spurs and stability.

Seek prompt assessment if you notice: progressive hand clumsiness, an unsteady gait, or weakness in the arms or legs — these can indicate cervical spinal cord compression (myelopathy), which is treated more urgently than nerve root pain alone.

Treatment Approach

Many cases of neck and arm pain improve with physiotherapy, anti-inflammatory treatment and time. When there is significant nerve or spinal cord compression, surgical options include anterior cervical discectomy and fusion, cervical laminectomy or laminoplasty to create more space for the spinal cord, or posterior keyhole foraminotomy for nerve root compression without the need for fusion.

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