Cervical Spondylosis

Cervical Spondylosis

Article
Bone, Muscle, & Joint
Diseases & Conditions
+1
Contributed byKrish Tangella MD, MBAMay 09, 2018

What are the other Names for this Condition? (Also known as/Synonyms)

  • Arthritis of the Neck
  • Cervical Osteoarthritis
  • Neck Arthritis

What is Cervical Spondylosis? (Definition/Background Information)

  • Spondylosis is a universal term that describes degenerative osteoarthritis of the intervertebral joints and spinal discs
  • Cervical Spondylosis is a degenerative disorder that involves abnormal wear on the vertebrae and soft tissues of the neck (cervical region). It is also known as Arthritis of the Neck
  • Individuals, who develop the condition begin to experience pain and stiffness of the neck, which usually increases with age
  • The outcome in a high percentage of cases involving Cervical Spondylosis is usually excellent, and most respond positively after a few weeks of treatment

Who gets Cervical Spondylosis? (Age and Sex Distribution)

  • Cervical Spondylosis may occur in individuals of all gender, age, race, or ethnic groups
  • It is a very common condition. Various studies estimate that about 9 in 10 adults will experience some degree of Cervical Spondylosis, by the time they reach 60 years old. However, a majority of them will not have any noticeable signs or symptoms

What are the Risk Factors for Cervical Spondylosis? (Predisposing Factors)

Common risk factors associated with Cervical Spondylosis include:

  • An advancing age
  • Studies have indicated that Cervical Spondylosis has a genetic prevalence. Children having immediate family members or relatives, with a history of the spinal condition are at an increased risk of developing this disorder
  • Smoking
  • Certain occupations that require excessive lifting of heavy objects
  • Past traumatic spinal injuries
  • Excess body weight associated with obesity, which can abnormally increase the pressure on joints
  • Ruptured or prolapsed cervical disc
  • Mental health problems, such as depression or anxiety

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Cervical Spondylosis? (Etiology)

Some of the causes of Cervical Spondylosis include:

  • Degeneration of the cervical disc, which causes the space between the vertebrae to narrow
  • Prolapse (slipping forward) of the cervical disc
  • Bulged cervical disc
  • Formation of bone spurs (osteophytes)
  • Stiffened ligaments due to advancing age
  • Enthesitis (painful inflammation at the site, where ligaments and muscles connect to the bones), due to joint injury, joint disease

What are the Signs and Symptoms of Cervical Spondylosis?

Signs and symptoms of Cervical Spondylosis include:

  • Excessive pain and stiffness of the neck
  • Numbness, feeling of weakness, tingling sensations in the arms, hands, and fingers
  • Muscle spasms in the neck and shoulder
  • Loss of bladder/bowel function
  • Difficulty walking

How is Cervical Spondylosis Diagnosed?

Diagnostic methods that a physician may use to help diagnose Cervical Spondylosis include:

  • Physical examination: The physician will perform a thorough physician examination, in addition to which, a complete medical history shall be evaluated
  • X-rays: An x-ray is typically the first diagnostic test performed. It shows if any abnormalities due to an advancing age are present in the spine
  • Computerized tomography (CT): A CT scan takes a series of x-ray images from several different angles, which are then merged to create cross-sectional images of bones and soft tissues with the body. This allows a physician to examine the spinal column and its surrounding structures
  • Magnetic resonance imaging (MRI): An MRI is a more detailed scan that uses radio waves and a magnetic field that generates thorough images of interior bones and soft tissues. An MRI can usually identify, if the spinal cord is compressed
  • Myelogram: A myelogram is a specialized diagnostic imaging procedure in which, a special dye is injected into the surrounding areas of the spinal cord. X-rays or CT scan images are then taken to help a physician detect any spinal abnormalities
  • Electromyography (EMG): An EMG shows the electrical activity of a muscle during rest and when they contract. Examining the electrical activities may help a physician observe any nerve damage, which along with other diagnostic tests, may provide very useful information about the condition
  • Nerve conduction velocity (NCV): NCV shows the speed at which electrical signals move through a nerve. Slow nerve signal speed may indicate a nerve damage

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Cervical Spondylosis?

Complications associated with Cervical Spondylosis include:

  • Loss of bladder/bowel function (urinary incontinence)
  • Functional impairment (clumsiness, sense of fine motor skills and coordination may be impaired)
  • Loss of muscle function
  • In rare cases, permanent disability may occur

How is Cervical Spondylosis Treated?

Methods for treating Cervical Spondylosis depend on the severity of signs and symptoms. The purpose of treatment is to relieve pain and stiffness, help resume regular/daily activities as early as possible, and prevent permanent damage to the spinal cord and surrounding nerves.

  • Wearing a specialized neck brace or cervical collar can help rest the neck muscles, while reducing the range of motion. This aids by reducing the irritation caused to the nerves in the neck
  • Applying a damp heated towel or an ice pack to the neck, can help reduce pain and swelling
  • Non-steroidal anti-inflammatory oral medications are commonly used to treat Cervical Spondylosis. These medications can help decrease the pain and swelling
  • Muscle relaxant medications may help, if individuals are experiencing painful muscle spasms in the neck
  • Corticosteroid injections into the epidural space (region near the spine, inside the vertebral column) help provide temporary relief of symptoms, and in improving the range of motion. It is important to note that corticosteroid injections only give temporary relief. Prolonged episodes of such injections, may injure the joints in the long-run
  • Narcotics are another type of medication, used to relieve pain. However, these are prescribed,only in case of excessive pain and for a limited time period
  • Certain types of epilepsy drug are also successful in reducing pain associated with the injured nerves

Surgical treatment is rarely required in individuals with Cervical Spondylosis. However, surgical procedures are recommended, if excessive pain and joint damage are present. The procedures include:

  • Anterior cervical discectomy and fusion (ACDF): This surgical procedure is performed through an incision within the front of the neck and involves removing a cervical herniated disc, to relieve pressure on the spinal cord and/or nerves
  • Anterior cervical corpectomy and fusion (ACCF): This surgical procedure is also performed through an incision within the front of the neck. Similar to ACDF, in this surgical operation the damaged or diseased vertebral bone and the surrounding cervical discs are removed. A bone graft material is then used to fill the empty space, and it is fused together with the cervical spine
  • Cervical laminectomy: This procedure is performed to relieve pressure on the spinal cord and/or the nerves that surround the cervical region (neck) of the body. The lamina bone of the vertebra forms the bony roof of the spinal canal, in the cervical region. During a cervical laminectomy, an incision is made in the lower back and the tissue causing pressure on the nerves removed. This helps creates more space within the spinal canal
  • Cervical laminoplasty: Cervical laminoplasty is another procedure performed to relieve pressure on the spinal cord and/or nerves located at the cervical region. During the procedure, an incision is made in the middle part of the neck, and tissue that is causing pressure on the nerves, is manipulated to widen the spinal canal

How can Cervical Spondylosis be Prevented?

Cervical Spondylosis is a progressive condition that is extremely difficult to prevent due to risk factors increasing with age. However, following certain guidelines may help slow the progression of the spinal disorder. These include:

  • Exercising regularly
  • Limiting or avoiding activities that may place an abnormal stress on the neck muscles
  • Begin any new physical activity slowly, with a thorough and complete warm-up. Individuals are advised to add low-impact activities to their exercise regimen to avoid repetitiveness
  • Individuals, who participate in any rough, high-impact sports (like football), should wear appropriate safety equipment to help decrease the risk of developing Cervical Spondylosis
  • Maintain correct posture while standing, sitting, or working at a desk (or on the computer). This can help avoid unwanted pressure on the spine
  • Maintaining a healthy body weight also helps avoid putting too much stress on the spine
  • Individuals, who maintain a healthy lifestyle may decrease the likelihood of developing Cervical Spondylosis, or at least slow down the progression of the condition

What is the Prognosis of Cervical Spondylosis? (Outcomes/Resolutions)

  • The long-term prognosis with Cervical Spondylosis depends on the severity of the degenerative disorder an individual develops
  • If the cause of Cervical Spondylosis is detected early and aggressive treatment provided; then, the quality of life can be substantially improved. This also prevents any serious complications from arising in the neck
  • Some individuals with the disorder are able to have a productive life. In others, this disorder may become debilitating and they may experience a gradual degeneration of the bones and cartilage within the neck, during their lifetime

Additional and Relevant Useful Information for Cervical Spondylosis:

Spondylosisis different from spondylolysis, which are small microfractures that occurs in part of the vertebral bones, within the spinal column.

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Krish Tangella MD, MBA

Pathology, Medical Editorial Board, DoveMed Team

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