Cervical Degenerative Disc Disease: What Is It?

Cervical degenerative disc disease (DDD) refers to a condition which the intervertebral disc in our neck region is degenerating. The intervertebral disc (IVD) is a rounded structure found in between each of our vertebrae. The functions of the IVD are to help with spine mobility, stabilization, and load distribution.

The IVD is composed of an outer layer called the annulus fibrosus (AF) and an inner layer called the nucleus pulposus (NP). The AF is made of type I collagen which acts as a protection layer for its inner content. On the other hand, the NP is made mainly of water. As we age, the NP slowly loses its water content and becomes more fibrotic (i.e., degeneration).

Cervical DDD happens when there are signs of degeneration of the IVD. And it could lead to or be accompanied by other disc problems, such as a tear in the AF; a protrusion of the NP content into AF (disc protrusion); an actual leakage of the NP content (disc extrusion); decrease in disc height; bone spur around the vertebrae; or even a fused spine.

In terms of diagnosis, MRI is the gold standard in evaluating a potential cervical DDD, since MRI allows visibility of soft tissues (ligaments, disc), bony structures (vertebrae), and neural structures (spinal canal, spinal cord). X-rays may also be beneficial in ruling out fractures or spinal instability.

The primary symptoms of cervical DDD include intermittent or constant pain, and possible neurological symptoms with or without pain.

Although cervical DDD is part of the normal process of aging, environment factors such as excessive use of electronics while sitting may predispose ourselves to cervical DDD. Chronic flexion of the neck can increase the stress on the disc. The weight of our head can increase by doubled or tripled as we flex our neck forward by 15-30 degrees beyond neutral.

Conservative treatments of cervical DDD include physiotherapy, with the primary goals to decrease pain, improve functions, and minimize recurrence and duration of symptoms. Physiotherapists will employ a variety of treatment techniques including but not limited to activity modifications, manipulations, acupuncture, cervical traction, heat, cryotherapy, education on proper posture, and home exercise program.

In summary, cervical DDD starts from degeneration of the disc’s content as we age and may progressively lead to other disc problems such as disc herniation, spinal fusion, pain, and many more. Diseases related to our spine are rather complicated. Therefore, if you are experiencing pain around your spine and extremities, consult your health care professionals as soon as possible!

Reference:

Fakhoury, J., & Dowling, T. J. (2020). Cervical Degenerative Disc Disease. StatPearls [Internet].