The gold standard of treatment for symptoms including long term neck pain, neurological deficits and radiculopathy stemming from the degenerative changes of the neck is an anterior cervical discectomy and fusion (ACDF). It has a very high clinical success rate but is also associated with some negative long term side-effects […]
Value based health care is swiftly becoming a thing of the present and substantiation of treatments for spinal conditions will be necessary. Optimal treatment options need to be identified in value-based health care, where optimal can be defined as greatest gain in quality of life at the lowest cost to […]
One’s neck mobility seems to gradually get worse as we celebrate birthdays and suffer our share of accidents and uncomfortable hotel pillows. The garden variety pain or achy stiffness in the neck, categorized in the healthcare world as ‘nonspecific neck pain’ sends a lot of people to their care providers […]
Problems in the neck that can cause severe pain, numbness down the arms, and sometimes even paralysis are referred to as cervical myelopathy. Cervical myelopathy can be caused by several changes that occur over time. The first is ossification (hardening) of the ligament that goes down the back of the […]
There are many ways to evaluate the results of treatment for severe neck pain and instability following cervical fusion or disc replacement. Change in symptoms (numbness, pain, loss of motion, loss of function) is a common source of information about what works well and what doesn’t. In this study, the […]
If you look at the average person from the side, the neck appears straight up and down. But, in fact, there is a backward curve called lordosis that helps keep the head and neck in perfect alignment. Injury, deformity, or arthritis can change this head-neck relationship causing a condition referred […]
The average single-level cervical spine (neck) fusion costs around $15,700. With the rising costs of health care, the question comes up: is this surgery really worth that much money? One way to measure the economic value of this procedure is to calculate the cost per quality-adjusted life year (cost/QALY) gained. […]
Disc replacements were first designed for the low back (lumbar spine). Their success in restoring pain free motion led to the development of a similar device for the neck (cervical spine). Although not everyone qualifies for a cervical intervertebral disc replacement, they seem to work well for those patients who […]
People with painful, unstable necks from degenerative disease have two surgical options when conservative (nonoperative) care fails to help. The first is still considered the gold standard (preferred choice) : anterior cervical discectomy and fusion or ACDF. The second is a total disc arthroplasty or disc replacement. Disc implants have […]
Step-by-step, orthopedic surgeons are finding better ways to treat neck and arm pain from degenerative disc disease of the neck. Severe neck pain and other symptoms down the arm (e.g., pain, numbness, tingling) are the usual reasons patients consider surgery for this problem. Over the years, advances and improvements have […]
It is agreed that if you have a disc replacement, it’s better than a fusion (in terms of motion). Movement of the spine is maintained with the implant (called a disc arthroplasty. But does a disc arthroplasty provide the same kind of spinal movement (called kinematics) as the normal, natural […]
The authors of this review of surgical treatment for painful cervical disc disease describe their work as “structured” and “rigorous.” And it is truly both! Using a series of carefully layed out tables, they walk us through what they found. They did a very thorough review of published studies comparing […]
Diffuse Idiopathic Skeletal Hyperostosis (DISH) is a condition in the spine caused by ligaments that turn into bone. Spinal ligaments along the front and back of the spine that help stabilize the spine are affected. The ligament along the front of the spine is called the anterior longitudinal ligament. The […]
Patients faced with a fusion procedure of the cervical spine (neck) for degenerative spine disease have several options to choose from. Fortunately, the surgeon will guide each person through the process. But who guides the surgeon in selecting the “just right” or “best” procedure for the patient? They rely on […]
Physical therapists often work with patients who have chronic neck pain from minor injuries. Most often, serious athletes and “wanna be” athletes (also known as “weekend warriors”) are affected. These are folks with minor sprains, strains, or contusions who develop loss of motion and motor control — sometimes without realizing […]
One way to break the pain-spasm cycle of chronic whiplash known as whiplash-associated disorders (WAD) is to treat the trigger points in the muscles. This is the finding of a new study from the University of Granada Department of Physical Therapy in Spain. Trigger points (TrPs) are hyperirritable spots in […]
Much has happened in the last few years related to disc replacements for the neck called cervical disc arthroplasty. The first FDA-approved studies on the subject have been published for three different devices: the Prestige System, the ProDisc-C system, and the Bryan disc. Since the first cervical disc replacement didn’t […]
There is a curious observation about patients who have a cervical spine fusion procedure when those patients are part of a Food and Drug Administration (FDA) study. They have a higher reoperation rate compared with people who have a cervical fusion outside of an FDA study. To be more specific, […]
Many people with neck pain never bother to seek help or get treatment for this problem. They just muddle along year after year making the best of their situation. After all, it’s not a condition that will kill you. It takes time to take off work for the doctor’s appointments. […]
Pressure on the spinal cord or spinal nerves in the cervical (neck) region can cause painful disabling symptoms. This condition is called cervical radiculopathy. Usually, it’s a herniated disc pressing on the nerve tissue that’s causing all of the problems. Painful symptoms can be managed with medication and physical therapy. […]