The cervical spine is comprised of seven vertebrae cushioned by intervertebral discs. Normal ageing produces wear and tear changes within these structures which may be demonstrated using X-rays or CT and Magnetic Resonance Imaging (MRI). These changes are seen in some adults from the third decade onwards and in the majority of patients do not cause symptoms.
As a consequence of these changes, areas of disc or bone may become overgrown and cause pressure on the spinal cord or individual nerves within the neck. Pressure on individual nerves within the spine usually causes pain which spreads down the arm to the hand. This pain may be associated with tingling or numbness in the fingers. Pressure on the spinal cord produces a distinct clinical syndrome known as myelopathy. Myelopathy usually causes a gradual deterioration in the function of the spinal cord. The first symptom is usually a gradual loss of dexterity with difficulty doing up buttons or handwriting. The legs may be affected and become stiff. Walking may be unsteady. Cervical myelopathy is usually relatively painless.