Cervical Disc Desiccation
Cervical disc desiccation is the age-related loss of water content within the intervertebral disc, representing the earliest stage of disc degeneration that leads to structural failure, height loss, and eventual biomechanical instability of the cervical spine. 1
Pathophysiology and Biomechanical Consequences
Desiccation occurs as the major risk factor of aging initiates the degenerative cascade, causing the nucleus pulposus to lose its hydration and shock-absorbing capacity 1
The loss of disc height occurs predominantly along the ventral (anterior) margin of the cervical spine, creating ventral angulation that progressively leads to loss of normal cervical lordosis 1
This altered biomechanics causes compression of neural and vascular structures as the spine transitions from its normal lordotic curve toward kyphosis if load balance is not restored 1
The degenerative process involves increased apoptosis (programmed cell death) of intervertebral disc cells and up-regulation of local inflammatory factors 2
Clinical Significance
Cervical disc degeneration from desiccation is frequently associated with neck pain and radiculopathy, though the relationship between imaging findings and symptoms remains complex 3
The degenerative disc develops a rich supply of nerve fibers and becomes prone to inflammatory reactions, making it susceptible to pain that can be provoked by disc stimulation 4
Disc degeneration is extremely common in asymptomatic individuals—in a study of 1,581 patients aged 18-97 years, 53.9% demonstrated disc degenerative changes, with prevalence and severity increasing with age 5
The critical clinical pitfall is that MRI findings of disc desiccation and degeneration must always be correlated with clinical symptoms, as false positives and false negatives are common 5, 6
Progression and Sequelae
The mechanical consequences of disc degeneration include segmental hypermobility/instability, posterior neck pain, radicular symptoms, myelopathic disturbance, and potential vascular compromise 3
Desiccation represents loss of structural integrity and failure of the intervertebral disc from a biomechanical perspective 3
The degenerative cascade results from imbalance of both static and dynamic spinal stabilizers, characterized by increased local inflammation and increased apoptosis of disc cells 2
Imaging Characteristics
MRI is the most sensitive imaging modality for detecting disc desiccation, showing decreased T2 signal intensity within the nucleus pulposus reflecting water loss 5
Radiographs demonstrate disc space narrowing and degenerative changes, though they are less sensitive than MRI for early desiccation 5
A high rate of detected abnormalities is noted in asymptomatic patients on MRI, making clinical correlation absolutely essential before attributing symptoms to imaging findings 5