Posts Tagged ‘cervical spine’

How Aging Affects Your Cervical Spine – Part I: Pinched Nerve

Pinched NerveThe cervical spine refers to that portion of the spinal column that is within our neck. This section of the spine has two essential roles: providing flexibility so that we can move our head up and down and side to side, and protecting the spinal cord nerves that pass through it. Cervical radiculopathy, or pinched nerve, tends to occur when the nerve roots are irritated or compressed by one of many conditions.


Cervical radiculopathy can occur in a wide variety of patients, with those younger than 50 tending to suffer as a result of disc herniations. Other than trauma or injury, degenerative conditions as a result of aging are the main cause of neck pain. As disks age, they lose height and the vertebrae move closer together, causing the body to respond by forming more bone—called spurs—around the disk to strengthen it. However, the spurs can also contribute to stiffening of the spine. Bone spurs may also narrow the area of the foramen and pinch the nerve root.


The primary symptoms of cervical radiculopathy include pain radiating from the neck into the shoulder, upper arm, forearm, or hand.  Sometimes the symptoms radiate into all of these areas, whereas in other cases, the symptoms may radiate to only some of these areas.  Other associated symptoms can include tingling and numbness.  In some cases, weakness of various muscle groups in the shoulder, arm, and hand may occur.



Interventional treatments for cervical radiculopathy are generally attempted first and may include:

  • Physical therapy and/or exercise to help relieve the pressure on the nerve root. Stretching as many dimensions of the neck as possible is essential to maintain flexibility and relieve chronic stiffness.
  • Medications, such as non-steroidal anti-inflammatory drugs (NSAIDs) to reduce swelling and pain and analgesics to relieve pain.
  • Use of a cervical collar, cervical pillows, or neck traction may also be recommended to stabilize the neck and improve alignment.
  • Injections of steroid medications around the affected nerve root, commonly known as nerve root or epidural injections, can be considered for pain relief as well.

Surgical Treatment:

If symptoms persist despite nonoperative care, or if there is substantial motor weakness, surgical treatment is recommended and generally has excellent outcomes.  In fact, cervical spine surgery generally has the best outcomes of any spinal operation.  Surgical treatment generally involves relieving the pressure off of the affected nerve root.  Depending on the circumstances, it may be performed either from the front (anterior) or back (posterior) of the neck, although the anterior approach is more common.

Some of the surgical spine procedures used to treat cervical radiculopathy at the Emory Orthopaedics and Spine Center are:

At the Emory Orthopaedic & Spine Center, our internationally-recognized spine surgeons research, pioneer and refine the most effective approaches to treating a variety of spine conditions.

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About Dr. Rhee

John Rhee, MDJohn M. Rhee, MD, is a Spinal Surgeon and Associate Professor of Orthopaedic Surgery specializing in cervical spine surgery, lumbar spine surgery, complex spinal deformity surgery (scoliosis and kyphosis) and surgery for spinal tumors. Dr. Rhee is an active researcher and sought-after teacher/lecturer at the national and international level in multiple medical societies. He has served as faculty and been an invited lecturer at numerous meetings and courses on spine surgery. In addition, he has served as Program Chairman at numerous national and international spine surgery meetings. Dr. Rhee has also published extensively in a number of peer reviewed journals and books, and he has received numerous awards and honors. He is actively involved the training of international research scholars and other spinal surgeons and has been the author and editor of major textbooks on spine surgery techniques.

Related Resources

3 Cervical Spine Procedures that Reduce Recovery Times

John G. Heller, MDWhen people think about neck conditions requiring surgery, they usually think about cervical spine injuries. We’ve all seen those tense moments during football or other sports when a player is injured and lies motionless on the field. A dramatic example comes from a Boston Celtics basketball game back in February, when Marquis Daniels bumped into another player and then fell motionless to the floor.

Fortunately, these events are rare. Most cervical spine surgery is needed because of wear and tear that affects your discs over time. In younger adults, this tends to be a herniated disc, which compresses the nerve roots or spinal cord. And, as we age, we all develop bone spurs to varying degrees (the “gray hair of the neck”). These spurs can be a source of nerve root or spinal cord compression, as well.

Cervical spine procedures are typically performed through the front of the neck, or anteriorly. In the United States, the primary surgical technique for the past 50 years has been the anterior cervical discectomy and fusion (ACDF). Since bone spurs form at the margins of the discs as they degenerate, these operations involve a discectomy, or the removal of the entire cervical disc, plus any bone spurs that border the discs.

Over the last two decades, spine surgeons at Emory have been leading the way in performing several innovative cervical spine procedures: laminoforaminotomy, artificial cervical disc, and laminoplasty. These procedures are performed from the back, or posteriorly, and don’t require a spinal fusion, thereby allowing patients to retain range of motion in the neck and also get back to their normal activities more quickly.

How do surgeons at Emory determine if one of these procedures might be right for you?

The first, laminoforaminotomy, is reserved for disc herniations that sit far enough to the side of the spinal canal that they do not compress the spinal cord. This procedure has been performed for many years, but new technology is allowing it to now be done using a minimally invasive microsurgical technique.

The second, for patients who meet the right selection criteria, is an artificial cervical disc, which may be inserted in place of the traditional bone graft with a plate and screws. This artificial disc is a moving part that’s ready for use when the patient wakes from anesthesia. Essentially, this procedure is a “get up and go” operation that avoids most of the limitations we traditionally impose on fusion patients while they heal. The artificial cervical disc is a ground-breaking option that has been very successful in clinical trials, many of which took place at Emory. Like any novel technology, longer term follow-up is needed to fully assess the risks and benefits of artificial cervical discs. But the data thus far are quite promising.

The third procedure, laminoplasty, is most often used in patients who are older and have three or more levels of spinal cord compression that would usually take three or four fusions. During this procedure, which is performed from the back of the neck, the roof of the spinal canal is re-shaped to provide more room for the spinal cord without the need for fusion. A mini-plate device, developed by surgeons at Emory Spine Center, is used during this procedure – allowing patients to move their necks right away after surgery, speeding up rehabilitation.

If you have been told you need cervical spine surgery, I would encourage you to contact the Emory Spine Center for an appointment to learn more about these innovative procedures.

Have you had or are you going to have cervical spine surgery? We’d like to hear about your experience. Please take a moment to give us feedback in the comments section below.

About John G. Heller, MD:
John G. Heller, MD, Baur Professor of Orthopedic Surgery and spine fellowship director, specializes in the research and development of instrumentation in cervical spine surgery, including disc arthroplasty and laminoplasty plates. He is the past-president of the Cervical Spine Research Society. Dr. Heller started practicing at Emory in 1989.