The cervical spine is the top area of the human spine. It consists of the first seven (C1 - C7) out of the total 33 vertebrae, separated by intervertebral discs. Any injury in this part causes pain around the neck region. However, not all kinds of neck pain necessarily mean that there is a cervical spine injury as the symptoms of such pain are quite different. An injury to the cervical spine is generally treated with cervical spine surgery. This article will cover both sides - symptoms, and treatments of cervical spine injury. In addition to this, you will also get to know about the rehabilitation process after the surgery. By the time you finish reading, you will be in a better position to understand if you are suffering from cervical spine injury and how you can go about treating it.
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The following symptoms indicate that the neck pain one experiences is due to an injury or deformity in the Cervical Spine.
According to the National Library of Medicine, causes of Cervical Spine Injuries can be classified into two types; Traumatic and Nontraumatic.
Traumatic Injuries
Trauma is one of the most common causes of injury to the spinal cord. A traumatic injury occurs due to a motor accident, falling, sport-related injuries, etc. Acute cervical spine trauma can cause grave injuries to the muscles, ligaments, and spinal cord. In some cases, spine discs get ruptured or displaced causing radiating pain and tingling in the arms and shoulders.
Nontraumatic Injuries
Over time, spine discs get degenerated due to wear and tear. Such damage to the spinal discs is nontraumatic however, it can cause a great deal of pain. Non-Traumatic causes of cervical spine damage also include osteoporosis, arthritis, or inflammation of the spinal cord.
There are different tests doctors use to diagnose spinal cord injuries:
Depending upon the severity of the damage, patient’s age, overall health condition, preference, and some other factors, the doctor will recommend surgical or nonsurgical treatments.
Most spine injuries, if not traumatic, can be treated with nonsurgical procedures. For example, neck pain due to cervical disc herniation can be cured with conservative treatments and surgery can be avoided. These methods include;
If patients do not show any improvement after being given nonsurgical treatments, the doctors prepare them for surgery. Depending upon the specifics of each case, the doctors can utilize different surgical procedures for treatment. Nevertheless, whichever surgical method is used, the goals are the same;
Generally, surgeons would use three types of procedures to fix cervical spine deformities;
1. Cervical Discectomy and Fusion
Cervical discectomy can be performed using two approaches; Anterior and Posterior. Both approaches are quite similar except for the fact that in Anterior Discectomy, the surgeon approaches the cervical spine from the front i.e., throat, and in Posterior discectomy, an incision is made at the back of the neck. In both surgical procedures, herniated or degenerative discs are removed. The approach to be used is determined by the surgeon based on the condition of the case.
Once the damaged part of the disc is removed, it is followed by spinal fusion to stabilize the spine. The basic idea of spinal fusion is to fill the gap created as a result of disc removal. For spinal fusion, surgeons use some bone material known as a bone graft. This material serves as a support to the vertebrae.
2. Cervical Laminectomy
Laminectomy is different from discectomy in a way that it is performed when the back of the vertebrae is damaged. So, in a laminectomy procedure the bony part covering the spinal cord is removed, whereas, in discectomy, part of the herniated or degenerative disc is removed. Laminectomy is commonly used to treat bone spurs of the spine associated with arthritis. During the operation, the surgeon removes the lamina relieving the pressure from the spinal cord and nerves. It is also followed by a cervical spinal fusion surgery that fills the gap created due to the removal of bone and makes the spine stable.
3. Cervical Disc Replacement Surgery
In Cervical Disc Replacement surgery, unlike Spinal Fusion in which vertebrae are fused, doctors replace the damaged disc with an artificial one. No bone graft is used, instead, the surgeon puts a new disc in place of the old one. It is considered to be a better procedure than fusion surgery as it preserves the mobility and motion of the spine.
Surgical spine treatments are to be carried out with extreme care and skill. According to research published by NIH, there are more than 10 risks associated with Cervical Spine Injury. These include; Adjacent Segment Disease, Leakage of Cerebrospinal fluid (CSF), Infection, Dysphagia, and Hematoma. Therefore, it is always recommended to consult a senior and expert neurosurgeon when it comes to getting invasive spine treatment. Discussed below are the details of some of the common risks involved in Cervical Spine Surgery;
Adjacent Segment Disease - In some cases of cervical spinal fusion surgery, patients can develop adjacent segment disease after the surgery. It is because in cervical fusion, two or more vertebrae are fused and this can influence the natural stability of the spine. As a result, discs adjacent to the fused vertebrae can be under greater stress to keep the spine together. This condition is known as adjacent segment disease. It can be normally treated with conservative procedures but in some cases, a second surgery might be needed to fix the problem.
Cervical Spine Infection - Mostly, infections occur at the surgical site within two to three days of the surgery. Infection is caused due to the bacteria that spreads to vertebrae from the blood. Experiencing chronic neck pain, fever, and dysphagia after the surgery are some common symptoms of post-surgical infection.
Hematoma - This is when blood accumulates in the tissues of the body and can be caused by bleeding within the spinal column or from any other injury on the spine. Hematomas can occur after any type of spinal surgery and are more likely to happen if there was any previous damage to the discs or nerves in your back before surgery.
Post-operative care of cervical spine surgery is essential to maintain the healing process and prevent complications. The surgical site should be kept clean, dry, and covered with a sterile dressing after surgery.
Rest - The patient should rest comfortably in the prone position until they can turn over and sit up without assistance.
Diet - They should drink plenty of water, eat nutritious meals and take pain medication according to their prescribed regimen.
If they have undergone a cervical fusion with hardware, then traction may be required for several weeks following surgery to help prevent contracture of the fused vertebrae.
Activity - Patients should be encouraged to sit up and start moving their necks slowly within a few days after surgery. This will help prevent stiffness in the neck muscles and reduce pain because it helps warm up the tissues around the area of treatment.
The most important thing is to follow all of the advice given by the medical staff. This will ensure that you get the best possible results from your operation. If there are any questions or concerns about your case, then you must speak to your surgeon about them as soon as possible so that they can advise on any further treatment required.
Rehabilitation after a spine surgery requires great discipline in terms of staying physically active and following the doctor’s instructions. The goal of rehabilitation is to regain full strength in your neck muscles so that you can perform daily activities without pain.
Spine diseases are not to be taken lightly. You need only the best of the best spine surgeons for any problem related to your back.
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