Cervical Disk Disease (Cervical Spine Disease)

Incidence in USA: 12,000 deaths/y; 70 million with cervical disk disease, spondylosis, or trauma

Disk disease a consequence of aging (3rd-5th decades)

Present in RA, ankylosing spondylitis, and other rheumatic disorders

Trauma, especially motor vehicle accidents

M:F ratio: 3:2

Mortality (acute) 1–5% (depending on associated injuries)

Spinal cord damage with C-spine movement

Difficulty intubating or reintubating postextubation

Swelling or hematoma after neck surgery, which can cause obstruction of airway

Steroid-induced complications

Airway management; C-spine movement during or after intubation

Exacerbating or causing spinal cord damage with neck motion

Osteoarthritis with osteophytes impinging on nerve roots

Neck pain: Present in 30% of adults in USA

Can cause radiculopathy, which can be aggravated by neck extension

Root:

• C3: Unusual

• C4: Numbness rare; pain at root of neck

• C5: Numb over shoulder to lateral aspect of upper arm (“epaulet” area)

• C6: Second-most common radiculopathy; pain across top of neck, along biceps muscle into tips of thumb and index finger, as well as biceps muscle weakness

• C7: Most common herniation, resulting in pain across back of shoulder triceps and into middle finger, as well as loss of triceps reflex

• C8: Numb small finger; weak interossei