- Degenerative neck condition fundamentals
- What causes the neck pain?
- What are my treatment options for neck pain?
- What are the risks of surgery for a degenerative neck condition? Is the surgery safe?
- How do I prepare for surgery?
- What happens after surgery?
- How long is the recovery period after surgery?
- What is the rehab after surgery?
- What are the Cleveland Clinic physician credentials?
- How do I make an appointment?
- What clinical trials are being conducted at Cleveland Clinic for degenerative neck conditions?
- Are there other resources that I can go to for more information on the spine surgery procedure?
- Why should I seek a second opinion regarding treatment for this procedure?
Degenerative neck conditions affect the cervical vertebrae – the seven vertebrae that form the upper part of your spine, between your skull and chest. When one or more of these bones is broken, the injury is called a cervical fracture. A cervical fracture can result in bone that is broken into pieces or cracks and fissures in the bone. This condition can often lead to severe neck pain. Other conditions associated with a cervical fracture (broken neck) include:
- Muscle sprain
- Dislocation of the flexible disks between the vertebrae
- Damage to the spinal cord
Serious falls and accidents are the most common causes of cervical fractures. Although prevention is difficult, wearing protective gear during certain activities – such as a helmet when playing football – protects the head area. Spine cancer can also lead to a cervical fracture. Spinal cord tumors can spread to the cervical vertebrae, resulting in fracture. Additionally, those with osteoporosis are more vulnerable to cervical fractures.
Symptoms of a cervical fracture may include:
- Severe neck pain
- Swelling of the tissue around the fracture
- Tenderness at the site of the fracture
To determine whether you have a cervical fracture, your doctor may order X-rays and MRI tests. Until a diagnosis is made, you must keep the neck immobilized.
The level and type of neurological impairment are related to the location of the neck damage, which is described in terms of the nearest vertebra.
A second major cause of degenerative neck conditions is cervical arthritis. This condition causes the cartilage in joints to wear away either due to an accident or age. These changes gradually narrow the space in the vertebra, causing nerve compression from the spinal cord in the neck. The nerves become inflamed, resulting in neck pain. Additionally, because the vertebrae are degenerating, even a minor injury to the neck can cause symptoms. Symptoms include:
- Chronic neck pain
- Muscle weakness and numbness
- Limited mobility of the neck
- Loss of balance
Minor fractures may require wearing a cervical collar until neck pain is healed. Non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, can be used to decrease swelling and relieve pain.
Most cervical arthritis cases respond to conservative treatment, such as resting the neck, using non-steroidal anti-inflammatory drugs (NSAIDs) to minimize pain and swelling, and being treated with a steroid epidural injected into the neck. Spine surgery is recommended for severe cases of cervical arthritis. The surgery involves the removal of a portion of bone to relieve pressure on the spinal cord.
More severe fractures may require manipulation or surgery to return the bones to their normal position. Traction may be used to align the bones with a halo-type brace. Plates and screws may be used with wires and bone grafts as well. Finally, surgery may be done to remove a portion of bone or a damaged disk to relieve pressure on the spinal cord.
During spine surgery, your doctor may remove all or part of the disk as well as any bone spurs. To reach the cervical spine, your surgeon will make an incision in the front or back of your neck.
After removing a disk from the front, your surgeon may fuse the vertebrae above and below the disk. This limits movement, helping to relieve neck pain and pressure. When performing vertebral fusion, your surgeon enlarges the space between the vertebrae and then "plugs" the space with a bone graft. Metal plates may be added for additional stability. As you heal, the graft and vertebrae grow together. Following fusion, your ability to bend your neck might be slightly restricted.
Risks include nerve injury, infection, bleeding, and stiffness.
To prepare for spine surgery, quit smoking if you smoke, exercise on a regular basis to improve your recovery rate, stop taking any non-essential medications and any herbal remedies which may react with anesthetics or other medications and ask your surgeon all the questions you may have.
Expect to spend up to four days in the hospital. Following surgery, you may have a drainage tube in your neck, which will be removed after a day or two. You may also have a brace to protect your neck, and your doctor will instruct you regarding when and how to wear it. You may need to wear it for up to three months.
Until instructed otherwise, keep the incision clean and dry. Refrain from driving, lifting objects and working until you obtain your surgeon's approval. Practice good posture to minimize neck pain.
Recovery times vary between several months to several years.
A physical therapist can inform you about exercises to rebuild neck strength and strategies for coping with the fracture.
- All doctors at Cleveland Clinic Center for Spine Health are board-certified or board-eligible in orthopaedic surgery or neurological surgery. In addition, our surgeons have subspecialty training and years of experience in spine surgery.
- All Cleveland Clinic staff radiologists are board-certified or board-eligible in radiology or have the international equivalent.
- All Cleveland Clinic staff rehabilitation specialists are board-certified or board-eligible in physical medicine and rehabilitation, or have the international equivalent.
- All Cleveland Clinic staff pain management specialists are board-certified or board-eligible in pain management or have the international equivalent.
Call 216.444.BACK (2225) or toll free 800.223.2273, ext. 42225, Monday through Friday, 8:00 a.m. to 5:00 p.m. (Eastern Standard Time).
What clinical trials and orthopaedic research are being conducted at CCF for degenerative neck conditions?
Researchers at Cleveland Clinic are involved in ongoing studies that investigate new drugs and treatment approaches for managing disease. Participants in these clinical trials can play a more active role in their own health care, gain access to new research treatments before they are widely available, and help others by contributing to medical research. There are currently more than 1,700 active clinical studies underway.
Patients can go to the following resources for more information on this procedure:
- Cleveland Clinic Health Information Center
- American Academy of Orthopaedic Surgeons
- North American Spine Society
- Spine Universe Website
As modern medical care grows more complex, patients can feel overwhelmed. The opportunity to consult a recognized authority about a particular diagnosis and treatment can bring peace of mind at an emotionally difficult time. A second opinion may be beneficial when:
- You are uncertain about having surgery.
- You still have questions or concerns about your current treatment.
- A controversial or experimental treatment is recommended.
- You have multiple medical problems.
- You have choices to make about treatment.
A convenient way to obtain a second opinion is e-Cleveland Clinic, a contemporary adaptation of The Cleveland Clinic’s 80-year tradition as a nationally designated referral center. An easy-to-use, secure, from-home second opinion service, e-Cleveland Clinic utilizes sophisticated Internet technology to make the skills of some of our specialists available to patients and their physicians, anytime, anywhere. With e-Cleveland Clinic’s personalized access, no patient need ever to feel unsure or uninformed when faced with what could potentially be one of the most important decisions of their life. Learn more about e-Cleveland Clinic.