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1#
The Ligaments
The vertebrae are held together by ligaments
to form one spine. Ligaments also form a capsule around the joints. The
ligaments help to maintain a harmonious movement of the spine. During an
accident if the ligaments is tom the movement will become abnormal and will
cause pain in the neck. Unfortunately, ligaments are not seen on X-ray. One
has to keep an open mind if one has to appreciate the problems of this kind.
Ligaments make an important contribution to the dynamics of the spine and
this in the causation of pain in the neck. Once a ligament is torn there is
abnormal movement which in turn precipitates the degeneration in the disc
resulting in added pain in the neck. The abnormal movement in the cervical
spine is accentuated once correctly conceived it can be treated in good time
to give relief from pain to the patient. With abnormal movement, the blood
vessels supplying blood to the spinal cord and get kinked. For want of blood
supply the cells of the spinal cord die and their function cannot be
retrieved by doing successful operation to prevent abnormal movement. This
is why once paralysis sets in, one of the contributing factors is lack of
blood supply and recovery becomes unpredictable. The neurological deficit or
paralysis in cervical spondylosis has more than one factor contributing to
it and the results cannot always be gratifying.
2# Spur or
Osteophyte
Under normal
circumstances, the bodies of the vertebrae are smooth at their edges. When
the disc degenerates, the edges of vertebral bodies start rubbing against
each other. This movement is rough and gritty as against the normal movement
with presence of normal disc when the movement is smooth. This movement is
abnormal and edges if the bodies develop bony spikes. They are pointed and
sharp. They are a source of pain in the neck and they can be seen on X-ray.
If one of these pointed spurs sokes into the nerve root, it causes severe
pain in the arm. Others can cause compression of the cord and produce
paralysis in the legs. Therefore if the X-rays of the spine show spur, then
one has to be more careful than others.
3# Abnormal
Movement
If an X-ray of the
spine is done at the age of 40 years, 30 persons of them show degenerative
changes and at the age of 50, almost 50 percent of the people would show
evidence of cervical spondylosis Not all have complained of the pain in the
neck and one has to be judicious in correlating the X-ray findings with
symptoms of the patient. Abnormal movements of a degenerated spine are not
smooth. There is no flexibility as elasticity in the ligaments and the
intervertebral disc is lost. Even a relatively minor blow can produce severe
pain the neck. Take the example of the driver whose head is thrown back when
his car is hit from behind. If the cervical spine is degenerated, then he
will get severe pain in the back and perhaps paralysis.
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