How to Diagnose Cervical Spine (Neck) Conditions


The doctor attending to cervical neck conditions is usually a neurosurgeon. The doctor records the medical history, symptoms and physical examination of the patient to begin with.

Depending on this, he may recommend either of the following imaging techniques to evaluate the extent of damage and work out the course of treatment for the patient:

MRI (Magnetic Resonance Imaging):

It creates images of the spinal cord, nerve roots evaluating them for degenerative changes, enlargement, herniation of the disc, infection or even tumours. It uses a strong magnetic field to produce these images.

CT (Computed Tomography) scan: 

This technique produces the image as a stack of multiple thin X-rays put together to evaluate the diameter of the spinal canal, its surroundings and its content, especially the bones. It is to evaluate the anomalies if any in the bones. These include osteophytes, bone destruction due to tumour, a fusion between two adjacent bones and bone spurs.

X-ray: 

This technique is to study the integrity of the bone structures of the vertebral column surrounding the spinal canal. The information extracted from this technique is the presence of arthritis, an arrangement of the spine, bone spurs, tumours or degeneration of the disc.

Electromyogram and Nerve Conduction Studies (EMG/NCS): 

Here the electrical impulse is applied along with the nerve roots, muscles and peripheral nerves. It allows estimating damage along nerves if there has been any, and that they are in the healing stages. Additionally to evaluate other nerve compression sites.

Myelogram: 

In this technique, a contrast material is injected in the surrounding spaces of the CSF spaces. Further, X-rays are taken to study the structures. It indicates the pressure exerted by herniated discs on the spinal cord or nerves, presence of any bone spurs or tumours.

What is the Treatment for Cervical Spine (Neck) Conditions


Conservative management in mild cases with neck pain (not involving trauma) involve bed rest, pain relievers and reduction of strenuous activities. 

Surgery is required in the following cases:

  • Conservative methods are not helping over a prolonged period of therapy.

  • The condition deteriorates indicated by symptoms that involve arms/legs.

  • Difficulty balancing while walking.

  • Overall good health.

The surgery is meant to achieve the following goals:

  • Decompressing the nerves and/or spinal cord.

  • Establish the stability of the spine.

  • Correct or maintain the alignment of the spine.

What are the Surgical Procedures ?


  • Anterior Cervical Discectomy:

The technique is used to relieve pressure impinging on the nerve roots and/ or spinal cord. An incision is made in the front of the neck.

A small horizontal cut in the natural crease of the neck is made for removing only one disc. In case of a longer surgery, a slanted and slightly longer cut is made on the anterior neck. The soft tissues are separated gently to approach the impacted area of the spinal column. 

The bone spurs and intervertebral disc are removed. The space in between bones is replaced with a small piece of bone or device through spinal fusion, to facilitate fusion of the bones gradually. 

  • Anterior Cervical Corpectomy:

It is a common treatment modality for cervical stenosis caused by bone spur formation leading to compression of the spinal cord.This is a preferred procedure when bone spurs cannot be removed only by a discectomy.

The surgeon may remove a part of the complete vertebral body to reduce pressure on the spinal cord. If there is multilevel pressure, accordingly one or more of the vertebral bodies may be removed along with their adjacent discs. 

This is replaced by a small piece of bone or device through spinal fusion that lets the new bone grow. The recovery for the neck to become stable after undergoing this procedure is much slower compared to discectomy as more bone is removed. 

The surgeon may support with posterior instrumentation and fusing the anterior construct. This depends on the extent of spinal reconstruction required.

  • Posterior Microdiscectomy:

It is a procedure used to remove a large, soft and herniated disc, which is putting pressure on a nerve root. The procedure involves making a small incision vertically in the back of the patient's neck, most often in the middle portion. 

  • Posterior Cervical Laminectomy and Fusion:

This procedure is to remove the lamina from the middle of the back neck. This is achieved by making a small incision in the back neck at the position of removal, generally the middle. 

The bone here is removed to rid either a thickened ligament, bone spurs or disc material that may be impinging pressure on the spinal cord. 

This procedure also allows enlargement of the foramen and removing any pressure on the nerves at their exit point from the vertebral column. 

The operating surgeon based on the degeneration of the column and the extent of the posterior spinal fusion requires help aligning the spinal cord and establishing stability to the degree of reconstruction. This will then reduce any future interventions at this level. 

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