Each year more than 200,000 cervical spine surgeries are performed in the United States to treat conditions ranging from cervical spinal deformities to degenerative disc disease. The cervical spine (vertebrae C1-C7) and the occipitocervical region (where the cervical spine meets the base of the skull) require precise treatment because injuries and conditions that affect that area can be life-threatening or severely debilitating.
Spine surgeon Dr. Darren Lebl answered questions on cervical spine disorders and how they are treated.
What are some common cervical spine disorders?
Age-related degeneration of the spine, which may have a genetic predisposition, can result in discs degeneration in the neck. This can result in impingement of the nerve roots or the cervical spinal cord, which can affect vital functions such as strength and sensation of the arms and legs and the ability to walk, breathe and function independently. Some patients are born with congenital anomalies in the cervical spine, which can substantially impair their daily lives. Traumatic conditions of the cervical spine may also occur in young active patients due to high-energy trauma or in elderly patients even from low-energy falls.
How do you treat those disorders?
There are a number of non-surgical treatments to try to improve patients’ mobility, function and pain. In some scenarios, surgery may be necessary, especially if the disorder compromises function of the nerve roots or spinal cord. Surgical options range from microsurgical techniques (e.g., decompression of nerve roots through a microscope) to complex reconstructive surgery of the neck.
How do I choose a cervical spine surgeon?
Cervical spine surgery training represents the intersection of orthopedic and neurological surgery. From an orthopedic perspective, the biomechanics of the cervical spine and health of the motion segments and mobility are studied. Cervical spine surgeons at HSS see patients with cervical disc herniation and cervical stenosis, and treat complex degenerative, traumatic and deformity-related conditions. In cases in which a tumor or other condition occurs within the dura (covering around the spinal cord), a spine surgeon with neurosurgical background would be better suited.
What mobility can a cervical spine disorder affect?
Cervical spine disorders can affect not only the mobility of the neck itself, but, if there is compromised function of the nerve roots, also can affect the ability to use the hands or arms. If there is compromise of the spinal cord itself, such injuries or disorders can affect the mobility of the entire body, as well the ability to use your bowel and bladder, to walk, and even the ability to breathe.
What does rehabilitation from a cervical spine procedure look like?
Where a focused problem is addressed with modern microsurgical techniques, patients can leave the hospital in one day and begin early range of motion activities soon after surgery with a physical therapist with the goal of quickly getting back to usual activities of daily living. In complex realignment and reconstructive procedures, recovery may involve a period of bracing that can last for weeks while the bone grafts heals.
Dr. Darren R. Lebl is an orthopedic surgeon at Hospital for Special Surgery who specializes in the microsurgical treatment of cervical spine conditions and complex cervical reconstructive procedures of the pediatric and adult patient. His practice utilizes a multidisciplinary approach to patient care focused on the improvement and treatment of underlying bone deficiencies, the use of biologic healing agents, and newer and less invasive techniques to surgically treat a number of spinal conditions.