Cervical Spondylitis

As we age, the joints and the discs present in the cervical area (neck) degenerates gradually, and the condition is termed as cervical spondylosis, also known as cervical osteoarthritis. The shrinking and dehydration of the cervical discs lead to osteoarthritis. It is estimated that more than 85 percent of people aged above 60 years are suffering from cervical spondylosis.

Your spine consists of vertebrae, discs, spinal cord, and nerve roots. With increasing age, the spinal discs tend to dehydrate and then get damaged. When your vertebral bones try to regenerate by itself, it causes overgrowth, leading to the formation of abnormal outgrowths called bone spurs. The chronic conditions may cause severe pain and stiffness. However, many people with cervical spondylosis can perform their daily activities.

Symptoms

In most of the people, the condition causes no signs and symptoms. The symptoms of cervical spondylosis primarily include neck stiffness and severe pain. Rarely, the condition may result from narrowing of the vertebral canal through which the nerve roots are passed to the rest of your body. If compression of these nerve roots occurs, then you may experience the following:

  • Numbness and weakness in your arms, legs, hands, or feet
  • Difficulty walking
  • Loss of bowel or bladder control

Consult your doctor immediately when you observe the above symptoms.

Self-management

If your cervical spondylitis is very mild and doesn’t have any severe symptoms, certain lifestyle measures would help you to prevent the condition. These include:

  • Exercising regularly
  • Applying heat or cold application on the affected area
  • Placing a soft neck brace to allow your neck muscles to rest

The causes of vertebral degeneration in cervical spondylosis include the following:

Dehydrated spinal disks : The spinal discs serve as cushions between the vertebrae of the spine. It consists of a gel-like substance that absorbs shock from twisting or any other activities. In older adults, these disks dry out and shrink which allows your vertebra to rub on each other causing pain.
Herniated discs: Sometimes, cracks appear on the spinal discs leading to leakage of gel-like substance. This causes bulging of your discs and compresses the spinal cord and nerve roots.
Ligament stiffness: The cords that connect your spinal bones, called as ligaments, become stiffer gradually affecting the movement of your neck.

Your doctor recommends the treatment based on the severity of the signs and symptoms. The therapeutic goal is to relieve pain and prevent permanent damage to your spinal cord. Your doctor might recommend any of the following therapies.

Medication : Your doctor might prescribe nonsteroidal anti-inflammatory drugs such as ibuprofen and aspirin; corticosteroids such as prednisone; muscle relaxants such as cyclobenzaprine; anti-seizure medications such as gabapentin and pregabalin; antidepressants; or pain relievers such as oxycodone. All these drugs help to relieve pain caused due to nerve damage.
Surgical therapy : If you do not respond to the medication therapy or other conservative treatment approaches, then your doctor might recommend surgery. The surgery may include either of the following:
  • Removal of herniated discs or bone spurs
  • Removal of a vertebral part that is affected
  • Use of a bone graft to fuse a segment of your neck

The initial diagnosis includes physical examination, where your doctor assesses the range of motion in your neck, the way you walk, and also tests your reflexes and muscle strength. To confirm the diagnosis, your doctor might order the following tests.

Imaging tests

  • Neck X-ray

    An X-ray of your neck and vertebrae are obtained to identify the abnormalities. It is also helpful to rule out other serious conditions causing neck pain.

  • Computed tomography scan

    The computed tomography scan provides a complete view of your bones and helps to diagnose cervical spondylosis.

  • Magnetic resonance imaging (MRI)

    MRI scan will help to identify the areas where the nerve roots are compressed.

  • Myelography

    Myelography is minimally invasive diagnostic procedure that involves injecting a dye into your spinal canal and X-rays were taken to obtain the detailed spinal structure.

Nerve function tests

Your doctor might recommend nerve function test to detect the abnormalities while transmitting the nerve signals to your muscles. These tests include:

  • Electromyography: The test is used to detect the electrical activity of your spinal nerves. As the spinal nerves transmit the electrical impulses to your muscles, the test examines the muscle during contraction and at rest.
  • Nerve conduction study This involves placing the electrodes on the nerve that is to be studied. The test measures the strength and intensity of the nerve impulse by passing a small shock through the nerve.

The factors that increase your risk of developing cervical spondylosis are listed below:

  • Increasing age : Often, cervical spondylosis develops due to structural changes in the neck that occur as you age.
  • Type of occupation : If your occupation involves frequent neck motions, lifting of heavy weights or awkward positioning may cause stress on your neck, resulting in degeneration of cervical bones.
  • Trauma : History of injuries to your neck increases the risk of cervical spondylosis.
  • Genetics : Certain genetic factors or family history of cervical spondylosis may cause cervical spondylosis.
  • Smoking : According to research studies, smoking has been linked to increased risk of cervical spondylosis.