Cervical Spine Disc Herniation Or Degenerative Disc Disease

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[edit] Cervical Spine Disc Herniation Or Degenerative Disc Disease

Shoulder pain can be secondary to degenerative disease in the lower cervical spine. This might involve the facet joints, the intervertebral discs or a combination of degenerative changes in all of these structures. Certain congenital malformations can predispose the patient to develop more serious degenerative changes.

For instance, with spondylolisthesis there is some overriding of one vertebral body over another, and this is such a condition where severe degenerative changes in the adjacent facet joints can occur coupled with severe narrowing of the disc space from underlying degenerative disc disease.Spondylolisthesis can also develop from repetitive trauma, particularly in adolescents and young active adults as this link shows and this can lead to spondylolysis, an acute surgical emergency.

This in turn can lead to a narrowing of the spinal canal (spinal stenosis),which can cause severe pinched nerve. These cases need a careful work-up by a neurosurgeon as some may need invasive neurosurgery, but others do best when left alone.

CT scans, MRI scans, myelography studies and bone scans are some of the diagnostic procedures that might have to be ordered. Symptoms in the shoulder are only one part of a symptoms complex. Other symptoms are neck stiffness and neck pain as well as loss of feeling in some or all fingers as well as weakness in the arm muscles. The patients who will need surgery might need an anterior discectomy and a cervical laminectomy. Part of the bone is removed to give the nerve root more breathing space. In other cases fusion surgery may be necessary.

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References:

1. ABC of rheumatology, second edition, edited by Michael L. Snaith , M.D., BMJ Books, 1999.

2. The Merck Manual, 7^th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999.

3. Goldman: Cecil Textbook of Medicine, 21st ed.(©2000)W.B.Saunders

4. Ferri: Ferri's Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.

5. Rakel: Conn's Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier

6. Wheeless' Textbook of Orthopaedics: http://www.wheelessonline.com/ Several topics can be found under this link by entering the term you search for.