Medical expert of the article
New publications
Cervical spondylosis
Last reviewed: 23.04.2024
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
Causes of the cervical spondylosis
Cervical spondylosis due to osteoarthritis is common. Sometimes, especially against the background of a congenital narrow (<10 mm) spinal canal, it leads to compression of the spinal cord with the development of myelopathy. Osteophytes of the intervertebral foramen, more often at the level of C5-6 and C7-8 can lead to the development of radiculopathy. Manifestations are determined by which structures are involved. An innately narrow canal increases the risk of cervical spondylosis.
Symptoms of the cervical spondylosis
Compression of the spinal cord usually leads to gradually increasing spastic paresis and / or paresthesias in the hands and feet, reflexes can be increased. An asymmetric nonsegmental neurological deficit is possible, which is aggravated by a cough or a Valsalva test, as well as by a centromedullary syndrome. Over time, at the level of damage, muscle atrophy and lax paresis of the upper extremities appear in combination with spasticity below this level.
Compression of the nerve roots leads to early onset of radicular pain, then weakness, reflex reflexes and muscle atrophy may develop.
About cervical spondylosis should be considered in the case when an elderly patient with osteoarthritis or root pain at the C5 or C7 level shows a characteristic neurological deficit.
Diagnostics of the cervical spondylosis
With the symptoms of the defeat of the cervical roots or spinal cord, MRI and electrodiagnostic studies (EMG, somatosensory and motor evoked potentials) are shown. Radiography of the spine with visualization of intervertebral foramen in oblique projections reveals osteophytes and decreases the height of the intervertebral discs, but the sensitivity and specificity of these changes are small. If the sagittal diameter of the spinal canal in the cervical region is less than 10 mm, the risk of spinal cord compression is high.
[8]
Who to contact?
Treatment of the cervical spondylosis
Sometimes the symptoms of cervical spondylosis spontaneously regress or stabilize. Conservative treatment includes wearing a soft orthopedic collar and taking NSAIDs or other mild analgesics. Cervical spondylosis is operated using decompression laminectomy, which is indicated with compression myelopathy, and with radiculopathy - with ineffectiveness of conservative treatment and / or electrodiagnostic confirmation of neurological dysfunction.
With the involvement of the spinal cord, a laminectomy is necessary, rear access reduces compression, but you must leave the front osteophytes, and as a result, the instability of the spine and kyphosis may develop, so now, front access is increasingly being resorted to. With isolated radiculopathy, non-surgical treatment with NSAIDs and wearing a soft cervical orthopedic collar is indicated. If inefficiencies may require surgical decompression.