I have two problems in my neck. The first is too much of a forward curve. The second is fairly severe disc degenerative disease. I may have surgery to fuse the spine in two places. Will this make my neck curve better or worse?
The human spine is made up of 24 spinal bones, called vertebrae. Vertebrae are stacked on top of one another to form the spinal column. The spinal column is the body's main upright support.
From the side, the spine forms three curves. The cervical spine (neck) curves slightly inward. An inward curve of the spine is called lordosis. The middle back, or thoracic spine, curves outward. The outward curve of the thoracic spine is called kyphosis. The low back, also called the lumbar spine, curves slightly inward.
A kyphosis of the cervical spine usually means the spine in this area loses its natural inward curve. It becomes straight or slightly bent forward. The effect of this position is to put increased pressure along the front of the spine segment (vertebrae).
The anterior (front half) of the vertebrae (when viewed from the side) compresses down. If this position is held long enough under pressure, the bone can become wedge- or pie-shaped.
Fusing two segments together doesn't usually change the curve of the cervical spine. The surgeon may perform reconstructive surgery to restore the natural cervical curve but this is unlikely.
Some studies show that kyphosis present before surgery doesn't create any additional problems after surgical fusion. But the loss of space around the spinal nerves from thickening of the ligaments along the back of the spine can lead to new onset of kyphosis. In these patients, there is an increased rate of stenosis (narrowing of the opening for the nerve structures) at the segment above or below the fused site.
At the same time, fusion of the spine in a position of kyphosis can cause lordosis above the fusion site. This, in turn, can cause adjacent segment disease (ASD). The altered mechanics and increased compression and force through the joint contribute to degenerative changes at the next level.
Ravi K. Ponnappan, and Alan S. Hilibrand. Cervical Spine. Adjacent Segment Disease of the Cervical Spine: Fact or Fiction. In Current Orthopaedic Practice. July/August 2008. Vol. 19. No. 4. Pp. 420-424.
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