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4# The Spinal Cord

If all the movement of the neck were to produce some damage to cord because there are spondylotic changes; then over a period of time, the spinal cord would get permanently damaged. In the beginning some pressure is thrust on the cord only during movements of flexion and extension. It is intermittent and does not cause significant damage. Later on, when spurs form, more constant damage is produced. Over a period of next few years, gradual but persistent damage to the cord starts producing paralysis in the legs or weakness in the arm. Part of the neurological deficit then remains permanently even after a successful operation.

5# Pain or Pressure or Tenderness

Whenever there is pain somewhere in the body, we usually try to point it with one finger pressed against the area which cause the maximum pain. However when this analogy is applied to the neck its is slightly different. If there is disorder of the movement or the movement is abnormal, the whole spine is affected. A pressure anywhere on the spine posteriorly will produce pain. We cannot then conclude that only the part under the pressed finger is pathological. In fact pathology could be anywhere, either in the posterior joint or in the intervertebral disc. From tender spot, its is impossible to locate the disease in the spine and we have to largely depend on the X-ray to evaluate the exact location and extent of the disease.

6# Noises in the spine

Noises in the joints are common phenomena. For some, it is tick. For some, it is a pleasure. many people prone to nervous disposition bend their fingers and produce noises. Some people turn their neck ti one side and produce a click. Such noises or clicks or sound in the cervical-spine get some of the patients extremely worried. They demonstrate such noises to the doctor in his consulting room. These sounds can be described as cracking, snapping or grinding noises. They may originate in an abnormal looking neck or they may be present without any abnormality in the joints. Many times they are produced after minor trauma to the neck and become a source of constant worry. Where does the noise come from? It is difficult to say. Evidence suggests that such noises are an expression of vacuum phenomenon in the joint. A thorough examination is necessary but if the examination does indicate any abnormality, noises by themselves are harmless and the doctor’s reassurance is sufficient to satisfy the patient. Noises by themselves are not significant as indicators of disease.

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