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Spondylosis

 

What is spondylosis?

Spondylosis is the abnormal wear on the cartilage and bones of the spine, which is a common cause of chronic neck pain. Over time, the disks, and cushions between the vertebrae of the neck and cervical spine can press down on one or more of the nerve roots, causing pain. In some cases, the spinal cord can become impacted as well. 

What causes spondylosis?

The gradual wear and tear of the cartilage and bones of the spine is an abnormal part of aging. Certain changes can take place, including:

What are symptoms of spondylosis?

The symptoms of spondylosis often develop slowly over time, but some may start suddenly. Common symptoms include:

  • Pain that can be mild or can be so severe that you are unable to move.
  • Pain over the shoulder blade.
  • Pain those spreads to the upper arm, forearm, or fingers
  • Neck stiffness that gets worse over time
  • Numbness or abnormal sensations in the shoulders, arms, or legs
  • Headaches, especially in the back of the head

How is spondylosis diagnosed?

To determine whether you have spondylosis, your provider will start with a physical exam that includes:

  • Checking range of motion in your neck.
  • Testing reflexes and muscle strength.
  • Watching you walk to determine if it is affecting your walk.

Imaging tests, such as X-ray, MRI, or CT scan may be necessary to provide detailed information to guide diagnosis and treatment. You may also need tests to determine if nerve signals are traveling properly to your muscles.

What are the treatment options for spondylosis?

Treatment for spondylosis is determined by the severity. The goal of the treatment is to relieve pain and prevent permanent injury to the spinal cord, while still getting you back to normal activities. The most common forms of treatment include:

  • Medications – if non-prescription pain relievers aren’t enough, your healthcare provider may recommend:
  • Therapy – physical therapy can teach exercises to strengthen muscles in your neck and shoulders and is one of the best ways for treating pain and stiffness.

If non-invasive treatment plans don’t work or your pain worsens, your provider may recommend surgery to create more room for your spinal cord and nerve roots. Surgery for spondylosis involves removing the tissue that is pressing on the nerve, called a decompression surgery. Then, a stabilization fusion surgery is done.

Decompression Surgery

There are four types of decompression surgeries. All of these surgeries are done from the back of the spine, with the rare occasion of performing from the front. Surgical options include:

  • Facetectomy – facet joints in your spine help to stabilize it, sometimes putting pressure on a nerve. This surgery removes the facet joint to relieve the pressure.
  • Foraminotomy – if part of the disc is putting pressure on a nerve as it leaves the vertebra, this surgery may be done to make the opening of the exit larger to allow the nerve to exit without being compressed.
  • Laminectomy – the lamina, which protects your spinal cord and canal, may press on your spinal cord. This surgery makes more room for the spinal cord by removing some of the lamina.
  • Laminotomy – similar to the foraminotomy, this surgery makes a larger opening in the lamina to allow room for nerves.

Stabilization Surgery

After a decompression surgery, your spine may be unstable. This puts you at risk for serious neurological problems, so a stabilization surgery is needed to prevent such risks.

In a stabilization surgery, the surgeon uses a bone graft, often from your hip, to fuse together the bones in your spine. They may use spinal hardware, such as screws, rods, plates and other devices to increase stability as the bones fuse. When healed, the fusion will stop movement between the vertebrae. 

Following surgery, it will take your body a while to recover. If you had a fusion, it would take several months or longer for the fusion to heal properly. It is important to follow your providers instructions to ensure proper recovery and reduce the risk of post-surgery complications.