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203-409-7240
Neck Pain
Mechanical Disorders
As a result of the natural wear and tear
that occurs with aging, certain parts of the cervical spine start to degenerate and wear
out, as we grow older. This process makes some of the anatomic structures of the cervical
spine, the bones, intervertebral discs, ligaments, and muscles less flexible and less
resistant to injury.
Degenerative Disc
Degenerative disc disease (DDD) is part of the natural process of growing older.
Unfortunately, as we age, our intervertebral discs lose their flexibility, elasticity, and
shock absorbing characteristics. The ligaments that surround the disc, called the annulus
fibrosis, become brittle and they are more easily torn. At the same time, the soft
gel-like center of the disc, called the nucleus pulposus, starts to dry out and shrink.
Degenerative disc disease is as certain as death and taxes, and to a certain degree this
process happens to everyone. However, not everyone who has degenerative changes in their
cervical spine has pain. Many people who have "normal" necks have MRI's that
show disc herniations, degenerative changes, and narrowed spinal canals. Every patient is
different, and it is important to realize that not everyone develops symptoms as a result
of degenerative disc disease.
Herniated Disc
There are soft-tissue discs between the bony vertebral bodies in your cervical spine that
are called intervertebral discs. These discs are composed of a soft gel-like center called
the nucleus pulposus, and a tough outer lining that surrounds the disc called the annulus
fibrosis. The intervertebral disc creates a joint between each of the vertebral bodies
that allows them to flex and extend, rotate slightly, and move with respect to one
another. When the outer lining that surrounds the disc tears, the soft center squeezes out
through the opening, creating a "herniated", "slipped", or
"ruptured disc". Each of these terms describes the same process.
Myelopathy
Myelopathy is a term that means that there is something wrong with the spinal cord itself.
This is usually a later stage of cervical spine disease, and is often first detected as
difficulty walking due to generalized weakness or problems with balance and coordination.
This type of process occurs most commonly in the elderly, who can have many reasons for
having trouble walking or problems with gait and balance. However, one of the more
worrisome reasons that these symptoms are occurring is that bone spurs and other
degenerative changes in the cervical spine are squeezing the spinal cord. Myelopathy
affects the entire spinal cord, and is very different from isolated points of pressure on
the individual nerve roots.
Radiculopathy
Doctors use the term radiculopathy to specifically describe pain, and other symptoms like
numbness, tingling, and weakness in your arms or legs that are caused by a problem with
your nerve roots. The nerve roots are branches of the spinal cord that carry signals out
the rest of the body at each level along the spine. This term comes from a combination of
the Latin word radix, which means the roots of a tree, and the Latin word pathos, which
means a disease. This disease is often caused by direct pressure from a herniated disc or
degenerative changes in the cervical spine that cause irritation and inflammation of the
nerve roots.
Spondylolysis
Cervical spondylolysis is a disorder that narrows the spinal canal in the neck compressing
the spinal cord or spinal nerve roots. It's a fracture or defect in the pars anticulars (a
portion of the bone between each of the joints of the back), allowing one vertebral body
to slide forward on the next. Spondylolyosis is sometimes referred to as pars
interarticularis defect. It may be unilateral or bilateral and is usually due to a
developmental defect but may be secondary to a fracture. Spondylolysis affects the area of
the vertebra called the pedicle. The pedicle is part of the bony ring that protects the
spinal nerves, and is the portion that connects the vertebral body to the facet joints.
It's a disease that often times affects middle-aged and older adults who have degenerative
discs and vertebrae in their neck. When a spondylolysis is present, the back part of the
vertebra and the facet joints simply are not connected to the body, except by soft tissue.
Stenosis
Stenosis is a term used to describe a narrowing of various parts of the body. Cervical
stenosis is a degenerative disease where the spinal canal and neural foramina narrow and
compress the spinal cord and nerve roots. Stenosis occurs when pressure increases
inflaming the facet joints. The facet joints are overlapping arches that form the spinal
canal. These joints are covered with cartilage and a membrane. Degenerative changes and
wear and tear can cause the facet joints to inflame. This disorder is most common in
people over 50 years of age. However, genetics and congenital factors may predispose a
person for stenosis.
Dr. Debra Petrucci
Please call for an appointment. 203-409-7240
Insurance Plans Accepted,
Medicare, Workman's Compensation NY, NY No Fault
Patients should check with their insurance plan for out of network plan
benefits.