The disc provides cushioning between the vertebral bodies and bears much of the load with the facet joints. The disc is made up of a jelly-type material in the middle called the nucleus pulposus and tough annular fibers surrounding the nucleus. The process of cervical disc degeneration occurs with age. DDD initially begins with small tears in the annulus which coalesce. Over time discs lose their hydration and proteoglycan content leading to structural changes and their ability to handle mechanical stress.
SYMPTOMS
Presents with neck pain worse with bending forward. May include pain or sensory symptoms in the arms suggestive of a nerve pinch. Cervical DDD is not always painful.
DIAGNOSTIC TESTING
Cervical x-rays can identify narrowing of the disc spaces. This is best seen on advanced imaging such as an MRI. MRI can show disc bulging, annular defects, changes in endplates, stenosis and more importantly how the nerve and spinal cord are affected.
TREATMENTS
Mostly treated non-surgically with anti-inflammatories, muscle relaxers, and Physical therapy. If symptoms are flared up and not responding to conservative measures, an epidural steroid injection (fluoroscopically guided injection of a steroid solution into the cervical spine) may be helpful.
PROGNOSIS
Cervical DDD is a part of natural aging. It is important to maintain activity, flexibility, and to stop smoking. Smoking accelerates degenerative disc disease.
