A peg-like upward extension in the spinal canal connects the first and second cervical vertebra in the neck to assist with head movements. This structure is referred to as the dens, or odontoid process. If calcium deposits form on this structure’s attached cruciform and alar ligaments, a “crown” (halo-like distribution) develops on top of the dens. The resulting condition is known as crowned dens syndrome (CDS). While not as common as whiplash and other conditions that affect the cervical spine, this inflammatory condition can still be the source of distracting neck pain. Los Angeles spine surgery experts at The Spine Institute discuss all the crucial details you need to know about CDS.
What Causes Crowned Dens Syndrome?
It’s not known why calcium deposits sometimes form on ligaments and affect the dens. CDS is a rare disease that may result in spinal cord compression and neck pain. Simply having bone deposits in the dens doesn’t necessarily mean any discomfort will be experienced. Most individuals with CDS have no symptoms. If symptoms do occur, patients may report feeling:
- Neck pain related to movement
- Stiffness in the neck
- Numbness or tingling sensations in the upper neck
- Fever
- Reduction in bladder control
How Is CDS Diagnosed?
Since CDS disease is rare, it’s not often the first consideration when a patient is having issues with neck pain. Diagnosis typically starts with an examination of the neck and an assessment of the neck’s flexibility and range of motion. If CDS is suspected, an X-ray or CT scan may be done to rule out other possible sources of neck pain and confirm the presence of calcium deposits. MRIs are not sensitive to calcification, although an MRI may show inflammation-related changes affecting the spine.
What Are the Possible Treatments?
It’s not unusual for the calcium deposits on ligaments to go away spontaneously, which may take anywhere from several days to several months. Treatment for CDS is typically conservative in nature (non-surgical). Non-steroidal anti-inflammatory drugs (NSAIDs) are sometimes prescribed to ease tissue swelling and give the affected ligaments time to heal naturally. If NSAIDs aren’t easing discomfort, steroid injections may be recommended. The injections are placed directly into the affected area of the neck, and a corticosteroid is combined with a local anesthetic to ease swelling around the dens and provide relief. Physical therapy efforts may include massage therapy, gentle adjustments, and hot or cold therapy.
Is Surgery Necessary for CDS?
In some cases, an inflammatory response occurs in joints and results in the formation of abnormal tissue (inflammatory pannus), which may contribute to compression of the cervical spine. If other treatment efforts aren’t effective, compression is severe, or the integrity of the spinal cord is compromised, the patient may need decompression surgery. Los Angeles residents can rely on Dr. Hyun Bae at The Spine Institute for their spinal surgery needs.
CDS is more common in women and older adults. It’s also more likely to be a progressive condition, although onset of symptoms may be sudden and primarily felt in the back of the neck. One way to minimize the risk of developing an inflammation-based condition such as CDS is to avoid sugary snacks, saturated fats, and other foods that often contribute to inflammation. While CDS sometimes goes away on its own, any lingering neck pain is reason enough to see your doctor.
You may also want to speak with a professionally trained spine surgeon to see what your options are for alleviating CDS. At The Spine Institute Center, we specialize in a wide array of fusion procedures and back fusion alternatives. Los Angeles patients who are experiencing chronic neck or back pain should call 310-828-7757 today to schedule an appointment.