Neck pain with radiating pain to the arm, is also termed cervico-brachial. Pain that goes from your neck-upper back region through to your arm-hand (upper limb) could be related to a compression of the nerve roots at your neck region of your spine, called cervical spine. A herniated or protruded disc at the cervical spine, bone spurs or narrowing of the spine (spinal stenosis) can causes a compression of the nerve root (at the side part, in the foraminal space), affecting your upper limb, or even the spinal cord (at the central part of the spinal canal), affecting all the four limbs. This can lead to pain, numbness and sometimes weakness affecting the arm-hand, and rarely the whole body below the neck region. This kind of cervical disc disease can affect one or multiple discs at the same time.
Main risk factors for neck (cervical) problems includes:
- Age: herniated disks can happen at adult or older age, causing the typical neck with arm pain; but disc degeneration, bone spurs and cervical stenosis (narrowing of the spinal canal and/or foramen), which can cause pain, numbness and even weakness to one or both arms, are more common among older people.
- Smoking cigarettes: increases your risk of having disc disease.
- Lifestyle: it’s suspected that twisting your neck and bad posture may lead to neck problems
Signs & Symptoms:
- Pain that radiates from your neck through to your arm-hand could be related to a compression of the nerve roots at your neck (cervical) region of your spine.
- The pain may range from being quite mild to severe. Some people experience it like an electric shock.
- The pain is often aggravated by coughing, sneezing or moving the neck.
- Some people have numbness, tingling or weakness in the affected arm or hand.
At King’s, a spine specialist will start to assess the patient with a medical history, physical exam, checking for muscle strength, sensation and reflexes. If necessary, imaging tests may be required. You may be asked to have an x-ray, MRI, CT scan and/or electroneuromyography (ENMG) for the proper diagnosis.
- The spine specialist will give you a plan for your neck pain radiating to the arm and/or hand (cervical radiculopathy or myelopathy) treatment, according to the case, and cervical disc problem can affect one or multiple discs.
- This plan could include medications, such as: anti-inflammatories, painkillers and muscle relaxants and physical therapy-rehabilitation program.
- Pain clinic and spinal injections can also be used to try to alleviate the pain.
- If the patient does not improve with conservative treatment, our spinal surgeons can proceed with the required surgical treatment to improve his neck problem due to cervical disc herniation, protrusion or related problem.
- The main indications for surgery for cases of cervical disc problem, like disc herniation, bone spurs and stenosis, are the following:
- Significant and persistent pain-numbness to the arm and/or hand.
- Weakness of the upper limb (arm or hand), and similar symptoms affecting the four limbs.
- Loss of body movements, balance and sensation (compression of the spinal cord).
- The spine surgeon usually uses microsurgical techniques to decompress the nerve and/or spinal cord, remove the affected disc, and replace the disc.
- This kind of surgery is usually performed through the front part of the neck (left or right side), using an anterior cervical approach to remove the disc, replacing the injured disc using an artificial disc (arthroplasty) for motion preservation; other cases are operated inserting a spacer and/or bone graft and plate to be fixed at the disc level (fusion technique); or a combination of both, using a hybrid cervical surgery, in some cases of multiple levels.
- There are other cases where the surgery is performed through the back part of the neck, for posterior decompression and/or fixation (laminoplasty, foraminotomy, cervical fusion, among others).
- The surgery can be performed using conventional, mini-open, minimally invasive spinal surgery (MIS), or microsurgical techniques, according to the case.
- In order to achieve the best results with lesser risks to the patient, King’s College Hospital Dubai offer the most advanced technology to perform spinal surgeries, including:
- Spinal neuronavigation, which is like a “GPS”, and “O-arm” for 3D image acquisition to assist the surgeon to locate the main anatomical structures and the spinal implants during all the main steps of the procedure.
- Intraoperative neuromonitoring to check the nerves and spinal cord during the operation to maximize the safety of the surgery.
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