Cervical Disc Disease eMedicine PMR

Description: Cervical disc disorders encountered in physiatric practice include herniated nucleus pulposus (HNP), degenerative disc disease (DDD), and internal disc disruption (IDD). HNP implies extension of disc material beyond the posterior margin of the vertebral body. Most of the herniation is made up of the annulus fibrosus. DDD involves degenerative annular tears, loss of disc height, and nuclear degradation. IDD describes annular fissuring of the disc without external disc deformation. Cervical radiculopathy can result from nerve root injury in the presence of disc herniation or stenosis, most commonly foraminal stenosis, leading to sensory, motor, or reflex abnormalities in the affected nerve root distribution. Understanding cervical disc disease requires basic knowledge of anatomy and biomechanics. The intervertebral disc absorbs shock, accommodates movement, provides support, and separates vertebral bodies to lend height to intervertebral foramina. The disc consists of an eccentrically located nucleus pulposus and a surrounding annulus fibrosus separating each segmental level between the C2-T1 vertebrae. No disc exists between C1 and C2, and only ligaments and joint capsules resist excessive motion. Disc degeneration and/or herniation can injure the spinal cord or nerve roots and result in stenosis and/or myofascial pain.
Synonyms and related keywords: annular tear, degenerative disc disease, DDD, disc degeneration, disc extrusion, disc herniation, disc protrusion, disc sequestration, discogenic pain, herniated nucleus pulposus, HNP, inflammatory radiculopathy, internal disc disruption, IDD, intervertebral disc herniation, radicular pain, radiculitis, radiculopathy, degenerative annular tears, cervical radiculopathy, nerve root injury, disc stenosis, myofascial pain, cervical disc disorder, central cord syndrome, CCS, spondylosis, neck pain, shoulder pain, Brown-Séquard syndrome, chemical radiculitis, nerve root compression, vertebral sclerosis, osteophytic formation, whiplash, dynatome, Spurling maneuver, abduction sign, repetitive cervical stress, smoking, atherosclerosis, cervical flexion injury, cervical rotation injury
Furman, Simon & Falco 2007