These patients may present with acute deterioration of their neurological symptoms following trivial trauma or whiplash type injury in the neck.Įxamination of patients with radicular pain may show weakness of specific muscles and dulling of reflexes while in patients with compression of the spinal cord may show increased tone of the muscles, weakness, decreased sensation as well as hyperreflexia. Patients with congenital cervical stenosis may be predisposed to such disease. There may also be hypertrophy and calcification of the ligament on the back of the spinal cord contributing to the stenosis. Patients may have disc degenerative disease of multiple levels causing multilevel cervical stenosis. These patients may also have hand dexterity problems in the form of dropping things, weakness of the grip strength, change in handwriting among others. Rarely patients may have disc herniation to the back in midline, which can compress the spinal cord leading to symptoms in one or all four extremities along with tingling, numbness, radicular pain, electric shock-like sensations, involvement of bowel or bladder and gait abnormalities. These radicular symptoms are caused by the disc herniation onto the side of the back of the disc thus compressing the nerve root.
A small percentage of patients present with symptoms of neck pain or that of compression of the nerve root on one side presenting with symptoms of radicular pain going down the specific dermatome in the arm, tingling, numbness, and rarely weakness of the muscles innervated by that specific nerve root. Vast majority of patients who have degenerative cervical disc disease are asymptomatic and remain asymptomatic throughout their life. When these herniations are along the back of the disc, they can compress over the spinal cord or the nerve root leading to variable symptoms and presentation PRESENTATION OF PATIENTS WITH CERVICAL DISC DEGENERATIVE DISEASE These tear allow the herniation of the central nucleus pulposus to the periphery. The degeneration causes decreased water content of the disc or desiccation which leads to tears in the outer ring or the annulus fibrosus.
The degenerative disc disease of the cervical spine usually involves the most mobile segment that is the C5-C6 followed by C6-C7 and C4-C5 disc levels.
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