SPONDYLOSIS

 

What is a Spondylosis?

The clinical term “Spondylosis’ mostly describes the degeneration of the spine, such as bone spurs and the degeneration of intervertebral discs between the vertebrae (Press, 2016). This degeneration usually impacts the mobility of the spine and affects the nerves and other normal functions. Physicians also coined this as a type of age-related arthritis related to the wear and tear of the spinal column. This degenerative process primarily affects the structures of the spinal column such as vertebral bodies, neural foramina, and facet joints. Spondylosis may induce pressure on the spinal cord or nerve roots, resulting in sensory or motor abnormalities such as pain, paresthesia, imbalance, and muscular weakness in the limbs.

Spondylosis can occur in any location of the spinal column, such as the cervical spine, thoracic spine, or lumbar spine. Although, the most common spondylosis occurs in the cervical and lumbar regions. Thoracic spondylosis usually produces no symptoms. Also, lumbosacral spondylosis can occur below the lumbar spine and affect both the lumbar spine and the sacral spine. Multilevel spondylosis also affects the multiple vertebrae in the spine. As a broad term, spondylosis closely relates to spondylolisthesis, spinal stenosis, sciatica, etc. that produces similar kinds of symptoms.

What are the Common Symptoms of Spondylosis?

Most patients with age-related spondylosis develop no symptoms. Some people experience symptoms for a short period of time before they disappear. A sudden movement can trigger some symptoms. Studies show that almost 27%-37% of people with lumbar spondylosis (spondylosis in the lower back) become asymptomatic, meaning produces no typical symptoms (Kolenkiewicz, Andrzej, & Wojtkiewicz, 2018).

Most patients with spondylosis develop back pain and neck pain due to nerve compression, sometimes known as a pinched nerve. Pinched nerves can cause pain in the neck or shoulders and develop headaches. Patients also experience stiffness and mild pain that grow worse after specific activities or lengthy periods of inactivity, such as sitting for a long time. Severe symptoms of spondylosis also include (Lv et al., 2018):

  • Tingling, numbness, or weakness in the arm, leg, or feet
  • Poor coordination and difficulty walking
  • Muscle spasm and weakness
  • Loss of bladder or bowel control
  • Grinding or popping feeling while moving the spine
  • Loss of balance

According to research, several complications can easily occur after having severe spondylosis. These includes:

  • Scoliosis
  • Cervical radiculopathy
  • Spinal stenosis
  • Cervical spondylitic myelopathy, etc.

These complications can make the symptoms worse. The location of the symptoms usually depends upon the area of the spine where spondylosis occurs.

What are the Causes of Spondylosis?

Spondylosis occurs because of constant abnormal pressure for a long time due to stress induced by sports, physical trauma, heavy injury, poor posture, joint subluxation, etc. Also, aging process leads the bone and cartilage of the spine to become wear and tear. This process can induce the development of some conditions, such as,

Spondylosis can affect any person of any age, but older patients show higher risk. Studies show that almost 80% of people after 40 years of age develop spondylosis on X-ray studies (Middleton & Fish, 2009). Risk factors for spondylosis may include old age, neck injuries, heavy occupation, genetic factors, smoking, alcohol consumption, etc.

How Do Spinal Specialists Diagnose Spondylosis?

Initial diagnosis of spondylosis starts with a physical exam that includes checking the range of neck motion, testing the reflexes and muscle strength of the patient, and looking after the posture to see any abnormalities in the gait. Physicians can use multiple techniques to confirm a spondylosis diagnosis. These techniques include (Binder, 2007):

  1. Imaging tests: Several imaging tests like X-ray, CT scan, MRI, myelography helps to provide detailed information about diagnosis and treatment of the patient.
  2. Nerve function test: Spinal specialists might recommend some tests to determine if nerve signals travel properly to the muscles. These tests include nerve conduction study and electromyography.
  3. Cervical compression test: This test includes flexing the patient’s head laterally and putting downward pressure on it. Development of pain on the ipsilateral side indicates a positive result of this test.

How Do Neurosurgeons Treat Spondylosis?

Treatment of spondylosis depends upon the severity of the signs and symptoms of the patient. The ultimate goal of this treatment lies to relieve pain and helps the patient to get their normal life as soon as possible. This also prevents further injuries to the spinal cord and nerve. Common nonsurgical treatment methods include:

  • Medications: This includes certain over-the-counter pain relief medications like NASIDs such as ibuprofen, corticosteroids, anti-depressant, anti-seizure medications and muscle relaxants to get rid of the symptoms quickly.
  • Physical therapy: This includes stretching and strengthening the muscles in the neck and shoulders to improve the condition.
  • Regular exercise: Performing low-impact exercises like walking or swimming can help to maintain the flexibility and improves the condition of the patient.
  • Decompressive therapies such as manual mobilization and mechanical traction also helps to alleviate pain.
  • Complete rest for a couple of days improves the condition dramatically.

Finally, if the above treatment fails, neurosurgeons suggest performing surgery. Current surgical procedures available to correct this condition may include decompression surgery, spinal fusion surgery, etc. Surgery helps to remove the herniated disc, bony spurs, or the part of vertebrae that causes pain. Please contact us for any queries.

References

Binder, A. I. (2007). Clinical Review Cervical spondylosis and neck pain. 334(march). https://doi.org/10.1136/bmj.39127.608299.80

Kolenkiewicz, M. B., Andrzej, W. B., & Wojtkiewicz, J. (2018). Diagnosis and Incidence of Spondylosis and Cervical Disc Disorders in the University Clinical Hospital in Olsztyn , in Years 2011 – 2015. 2018.

Lv, Y., Tian, W., Chen, D., Liu, Y., Wang, L., & Duan, F. (2018). The prevalence and associated factors of symptomatic cervical Spondylosis in Chinese adults : a community-based cross-sectional study. 1–12.

Middleton, K., & Fish, Æ. D. E. (2009). Lumbar spondylosis : clinical presentation and treatment approaches. 94–104. https://doi.org/10.1007/s12178-009-9051-x

Press, D. (2016). The incidence of cervical spondylosis decreases with aging in the elderly , and increases with aging in the young and adult population : a hospital- based clinical analysis.