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Spondylosis
Cervical spondylosis is a disorder caused by abnormal wear on the cartilage and bones of the neck (cervical vertebrae) with degeneration and mineral deposits in the cushions between the vertebrae (cervical disks).
Signs and symptoms
Neck pain and stiffness that gets progressively worse may be an indication of cervical spondylosis. The pain may range from mild to severe and debilitating. The condition may last for several months before improving, or it may become chronic. Other signs and symptoms may include:
- Neck pain that radiates to the shoulders and arms
- Numbness or weakness in the arms, hands and fingers
- Headaches that radiate to the back of the head
- Loss of balance
- Numbness or weakness in the legs, if the spinal cord is compressed
- Loss of bladder or bowel control, if the spinal cord is compressed
Causes
Cervical spondylosis results from chronic degeneration of the cervical spine including the cushions between the neck vertebrae (cervical disks) and joints between the bones of the cervical spine. There may be abnormal growths or "spurs" on the vertebrae (the bones of the spine).
These accumulated changes caused by degeneration can gradually compress one or more of the nerve roots. This can lead to increasing pain in the neck and arm, weakness, and changes in sensation. In advanced cases, the spinal cord becomes involved. This can affect not just the arms, but the legs as well.
A previous neck injury (which may have occurred several years prior) can predispose to spondylosis, but the major risk factor is aging. By age 60, 70% of women and 85% of men show changes consistent with cervical spondylosis on x-ray.
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Risk Factors
Aging and wear and tear on your spine are the major risk factors for cervical spondylosis.
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Screening and diagnosis
A pain in the neck that continues to get worse is a sign of cervical spondylosis. It may be the only symptom in many cases. Examination often shows limited ability to flex the head to the side (bend the head toward the shoulder) and limited ability to rotate the head. Weakness or sensation losses indicate damage to specific nerve roots or to the spinal cord. Reflexes are often reduced.
- A spine or neck x-ray shows abnormalities that indicate cervical spondylosis.
- A CT scan or spine MRI confirms the diagnosis.
- A myelogram (x-ray or CT scan after injection of dye into the spinal column) may be recommended to clearly identify the extent of injury.
- An EMG may also be recommended.
- An x-ray of the lower (lumbar) spine may reveal degenerative changes in this region.
Treatment
The goal of treatment is relief of pain and prevention of permanent spinal cord and nerve root injury.
In mild cases, no treatment is required. Symptoms from cervical spondylosis usually stabilize or regress with simple, conservative therapy including a cervical collar (neck brace) to restrict motion and non-steroidal anti-inflammatory medications (NSAIDs). Cortisone injections to specific areas of irritation may also be helpful.
Rarely, intermittent neck traction may be recommended instead of, or in addition to, a cervical collar. This usually consists of a halter-like device placed on the head and neck and attached to pulleys and weights.
For severe cases, hospitalization with complete bedrest and traction for 1 or 2 weeks may be needed. Narcotic medicine or muscle relaxants may help to reduce pain. Surgical decompression of the spinal cord in the neck may be recommended for severe pain or for significant loss of movement, sensation, or function.
Surgical procedures may involve removal of bone and disk tissue impinging on the nerves of the spinal cord and stabilization of the neck by fusing the cervical vertebrae.
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Prevention
Many cases are not preventable. Prevention of neck injury (such as proper equipment and techniques when playing sports) may reduce risk.
However, you may be able to reduce your risk by:
- Skipping high-impact activities, such as running and high-impact aerobics, if you have any neck pain
- Doing exercises to maintain neck strength, flexibility and range of motion
- Taking breaks when driving, watching TV or working on a computer to keep from holding your head in the same position for long periods
- Practicing good posture, with your neck aligned over your shoulders
- Protecting your neck from injury by using a seat belt when in a car and avoiding activities that strain your neck
Information obtained from National Institute of Health