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Cervical Spondylosis


What is cervical spondylosis? 

Cervical spondylosis is the general term for wear and tear of the spinal disks in the neck. As we age, the cervical discs dehydrate and lose their elasticity and height. This leads to more stress on the junction between the disc and the vertebra and causes osteoarthritic changes at the disc/vertebra junction promoting the formation of bone spurs (osteophytes). These bone spurs along with loss of height of the disc can lead to narrowing of the spinal canal which can cause irritation/compression of the nerves and spinal cord. Cervical spondylosis is very common and worsens with age. Most people experience no symptoms from these degenerative changes. However, if the spinal cord or nerve roots become pinched, one could experience the following symptoms: pain involving the neck, head and arms, numbness/tingling/weakness in the arms, difficulty walking. Risk factors for developing cervical spondylosis include: age, occupation (jobs that involve repetitive neck motions or overhead work), genetics, and smoking.

How is cervical spondylosis diagnosed?

The symptoms include chronic neck pain/headaches and pain radiating into the shoulder blade and arm if there is irritation of a nerve. There is decreased range of motion of the neck due to increased neck stiffness. Neck pain can worsen with motion and be tender to touch. Weakness or loss of sensation in the arm can also be present if there is more significant nerve damage. MRI of the cervical spine is the best study to evaluate for spondylosis. A CAT scan study may also be useful since it can show bone spurs well. 

What is the treatment for cervical spondylosis?

Treatment for cervical spondylosis involves exercise/self care, medications and physical therapy.  Gentle neck range of motion exercises, heat/cold therapy, and anti-inflammatory medications are effective for most patients. If neck pain symptoms last for more than several weeks, then physical therapy should be tried. Neck injections, including trigger point injections (for tight muscles), epidural steroid injections (to relieve inflammation in the nerves) or facet injections (to relieve joint inflammation) may help alleviate a neck pain exacerbation. 

Surgery for cervical spondylosis may be considered for persistent neck pain that is not relieved with conservative care or for persistent cervical radiculopathy (pinched nerve) or cervical myelopathy (compression of the spinal cord). The surgery typically involves a combination of decompression (removing disc/bone spur pressure off a nerve/spinal cord) and stabilization of the spine.

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