Cervical spondylosis, also known Cervical Spondylitis, is a common degenerative disease that affects the bones in the neck (vertebral bodies) and the intervertebral discs. It is usually a consequence of advancing age or undue mechanical stresses.
Many people with cervical spondylosis have no symptoms whatsoever.
In those who are symptomatic, pain and stiffness of the neck are common. The pain may vary from mild to severe. It may worsen with neck movements and or with activities such as reading and driving where the neck is held in the same position for a long time.
Other symptoms include:
Creaking when turning your neck
Loss of balance
The weakness of the upper and lower limbs
Numbness of arms, hands, or fingers
In severe cases where the spinal cord is compressed, bladder and bowel function are impaired.
If nerve roots arising from the spinal cord are compressed, the pain radiates to other areas of the body such as arms, shoulders, and head.
After obtaining a brief medical history and physical examination, your doctor would recommend some tests. During the physical examination, your doctor will check your neck, shoulders, arms, and legs. The examination will include testing of:
Strength of your arms, hands, and fingers
The flexibility of your neck and arms
Gait (how you walk)
Different types of sensations
Your healthcare provider will order some tests to confirm the diagnosis, including:
X-rays and Computed tomography (CT): Give information about dense structures such as bones. It will provide information about the extent of degenerative changes in the cervical spine
Magnetic resonance imaging (MRI): Allows to show a better view of the nerves, discs, muscles, and spinal cord.
Myelogram: A type of CT scan where a contrast dye is injected into the spinal canal for getting a better image of the spinal cord and nerve roots.
NCS (Nerve conductions Study) and Electromyography (EMG): Measures the electrical impulses in the nerves and evidence of involvement of muscles that they innervate.
Most cases of cervical spondylosis are resolved by non-surgical treatment. However, some patients may require surgical intervention.
Physical therapy: Performing specific exercises to ease the pain and to strengthen the muscles. In a few cases, the use of traction may be needed. Physical therapy is usually done 2-3 times per week and lasts for 6-8 weeks.
Medications: Drugs are used to relieve pain and inflammation. Some common medications used include
Nonsteroidal anti-inflammatory drugs
Cervical epidural block: Steroid and anaesthetic drugs are injected into the epidural space. This technique is used for neck and/or arm pain.
Cervical facet joint block: Steroid and anaesthetic drugs are injected into the capsule of the facet joint.
Ice, heat: Applying ice or heat may alleviate symptoms temporarily
Soft cervical collar: A padded ring that stays around your neck and held in place with Velcro. This is done to limit any neck movement. It should be worn for a short period only.
Surgical treatment is usually not recommended unless your healthcare provider finds:
Cervical radiculopathy - the spinal nerve is compressed by a bone or a herniated disc
Cervical spondylotic myelopathy - spinal cord is compressed
Surgery may also be recommended if there is severe pain that is not responsive to conservative treatment.
Surgery usually involves removing bone spurs, a part of the vertebra or fusing a segment of the spine using bone grafts or other techniques.
As you age, your spine goes through changes. Degeneration is one of the causes of cervical spondylitis where your discs become thinner. A herniation is another cause wherewith age, your spinal disc tears or cracks. Other causes include osteoarthritis and bony spurs.
Old age is a common risk factor. Other risk factors include genetics, smoking, previous neck injury, and heavy lifting. Straining your neck for many hours or keeping your head in an uncomfortable position for many hours are risk factors as well.
With age, your spine changes. By the time you are in your 30s, your spine begins a wearing-down process. 9 out of 10 people will have cervical spondylosis by the age of 60.
Maintaining a good posture, doing appropriate exercises to strengthen the muscles around the spine, and avoiding injuries to the neck may help in delaying the onset of spondylosis. When playing any sport, make sure you use the right equipment to prevent stress to the spine.
Most early symptoms such as pain can be treated at home with medications and simple lifestyle changes. However, some people may develop complications such as bone spurs, disc herniation, and nerve compression. In these types of situations, more medical attention is required such as stronger medications, steroid injections, and surgery. This would vary from person to person.
HOD And Consultant - Department Of Neurology
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