Cervical spondylosis has been affecting middle-aged and elderly around the globe.. According to a study done in Cleveland Clinic (USA), people above the age of 60 years have 90% incidence of cervical spondylitis.However that goes without question that many of these subjects never report any symptoms, however some may show up in medical OPD days with significant amount of neck pain, radiating pain and other host of symptoms.

So looking at this widespread incidence there comes  a question: what is cervical spondylosis ?

Cervical Spondylosis is basically the aging or wear and tear of the cervical spine,spondylitis meaning inflammation of spine..Cervical spine refers to the spinal bones in your neck which basically connects your head to the chest. Cervical spondylosis leads to degeneration (arthritis) of various structures in the musculoskeletal framework of the spinal bones in the neck .This includes the degeneration of of spinal ligaments, spinal discs , overgrowth of bones and various other degenerative changes in the structure of spine which may lead to compression of nerve roots and hence the symptoms associated with cervical spondylosis.

In this article we will briefly go through the various highlights about cervical spondylosis and what are the treatment strategies associated with it.

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Symptoms of Cervical Spondylosis

 

 

Spondylitis symptoms with which patents present in OPD can be classified into common symptoms and less frequent symptoms.

Common symptoms of Cervical Spondylosis :

1. Pain in Neck

2. Pain in Shoulders.This may include paid radiation in the whole of the shoulder blade on either side or sometimes on both the sides.

3. Pain on either side in between of the shoulders on the back side. This is generally a very classical feature of cervical spondylosis and generally refers to C5 C6 nerve root compression.

4. Pain radiation in upper Limbs, arms , forearm or till fingers.

5. Feeling of tingling and numbness in fingers and hands.

 

 

Less Common (& Advanced) Symptoms: 

1. Weakness in upper Limbs. This may be elicited by the fact that the patient will avoid doing final jobs with the affected hand including holding a cup of hot liquid like tea or writing with it. Some people complain of change in handwriting and unable to do fine jobs like putting the thread in the needle etc. Later the weakness of upper Limbs will be so extreme that the patient is not able to eat with his/her own hands. 

2. Tingling and numbness in the whole body including legs.

3. Weakness in the whole body, loss of balance, and inability to walk.

4. Loss of bladder & Bowel control.  

 

 

Causes of Cervical Spondylosis

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Multiple causes of cervical spondylosis have been identified. We will be discussing a few of the major causes which lead to cervical spondylosis.

1. Bony Spur : Sometimes in order to stabilize ageing spine, the human body tries to auto repair itself and tries to form excess bone at the edges of the spinal bodies. This leads to access bone formation which in turn starts to compress nerve roots and leads to severe symptoms of cervical spondylosis. 

2. Degenerated Discs: Also called black discs which lead to Cervical Spondylosis as they decrease the shock absorbing capacity of the cervical spine. These degenerated discs in comparison to normal healthy disks look black in colour as the water content inside the disc are low and can be easily identified on MRI scans.

3. Herniated Discs :Also known as slip disc of cervical spine ,a herniated disc usually leads to radiation of pain in the shoulder upper Limbs and in severe cases in the lower Limbs also.

4. Injury : Any injury or insult to the cervical spine may lead to early onset degeneration of the cervical spine leading to early onset cervical spondylosis. 

5. Stiffness of Spinal Ligaments :Lack of exercise & increasing age leads to stiffness in the ligaments of the cervical spine .sometimes these ligaments also get embedded with calcium (Bone Forming) leading to permanent stiffness. This decreases the mobility of the cervical spine and increases the chances of wear and tear and hence resulting in cervical spondylosis .

 

 

Risk Factors in Cervical Spondylosis

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Multiple risk factors leading to Cervical Spondylosis have been identified. However many of these risk factors can be modified in order to prevent or delay the onset of cervical spondylosis as well to stop the progression of the disease in the ones where it has already set in. however some factors are beyond the control & are called non modifiable factors. The list is under :

1. Advancing Age : Already stated above multiple studies suggest that there is a high possibility of cervical spondylosis with people above the age of 60.

2. Smoking : Smoking is positively associated with increased chances of cervical spondylosis.

3. Familial : Genetics also plays a major role and Cervical Spondylosis problems are known to run in families. 

4. Lifestyle : Patients who are overweight and who prefer a stagnant lifestyle with no regular exercise routine are prone for Cervical Spondylosis.

5. Regular Neck Strenuous Activities :Jobs and activities which involve keeping the neck in one position for extended periods of time are known to injure the cervical spine and can cause Cervical Spondylosis earlier than expected. 

 

 

Home Management & Precautions

 

 

Now the question comes you already have cervical spondylosis and there are symptoms which are bothering you. What kind of precautions can you take at home ?

 well if your symptoms are mild Cervical Spondylosis can be managed at home. cervical spondylosis home treatment remedies as discussed under.

1. Avoid using a large pillow. ( especially when sleeping straight)

2.  apply heat packs or cold packs over the neck and Shoulders 

3. You can learn a few Cervical Spondylosis exercises with the help of your physical therapist and they can be done at home safely .

4. Avoid keeping your neck bent for a long time and follow a general good diet.

5. Over-the-counter medications like paracetamol can be tried.

 

 

When to see a Spine Specialist

 

 

So if home remedies fail or if the symptoms are rapidly progressing with no sign of relief you should visit your spine specialist or spine surgeon in order to be fully evaluated for various symptoms you are having. However there are few Red flag signs which need to be taken care of. is any of these undermentioned attack science appear you should consult your spine specialist surgeon immediately :

RED Flag Signs

1. Severe weakness in upper Limb and lower Limbs

2. Inability to Walk or loss of balance 

3. Loss of control of bladder function or Bowel function.

4. Things start to fall from hand due to weakness.

 

 

Cervical Spondylosis Treatment

 

 

Conservative Non-Operative Treatment

Majority of cervical spondylosis cases can be managed conservatively, that is to say without the need of any surgical procedure.

There is more than 90% remission rate of patients of cervical spondylosis by standard Strategies.

1. Physical Therapy : After consultation with your spine surgeon you may be advised to undergo a physical therapy under a qualified physiotherapist who will give you a definite set of exercises for cervical spondylosis as well as multiple modalities which leads to decrease in inflammation in the cervical spine.

2. Analgesics & Anti Inflammatory Drugs : a short course of analgesics and anti inflammatory drugs also help in Rapid cure of cervical symptoms as well as aids in Breaking the pain cycle.

3. LifeStyle Changes : After discussion with your spine surgeon careful steps can be taken to change your daily work routine, exercise routine, the way you sleep etc. All these steps are taken to ensure that you progressively de-stress your cervical spine.

 

Imaging & Tests:

Depending upon severity of your Cervical Spondylosis symptoms.Chat treating spine surgeon may advise you to undergo a few investigations which may include the following:

1. MRI SCAN of Cervical Spine

2. X Ray of Cervical Spine

3. Nerve Conduction studies

4. X Ray Myelogram of Cervical Spine

Conservative Operative Management:

If the symptoms of spherical Spondylosis don’t get better by giving adequate amounts of conservative management strategies as discussed Above and the patient is still suffering because of cervical pain the surgery is offered as a last and final Resort treatment for Cervical Spondylosis.

There are various types of surgeries performed in Cervical Spondylosis which include the following :

1. ACDF : Anterior cervical discectomy and fusion.

2.  anterior cervical disc replacement

3.  posterior cervical laminotomy

4.  posterior cervical laminectomy

5.  posterior cervical endoscopic discectomy 

6. Posterior cervical decompression and fusion 

Nowadays most of the surgeries are done through endoscopic and microscopic  techniques. All techniques help to reduce the amount of bleeding and help in wound healing faster. at our Institute we are dedicatedly performing only minimally invasive spine surgery and endoscopic spine surgery techniques. 

 

 

Conclusion & Living With Spondylosis

 

 

Living with Cervical Spondylosis requires a significant amount of strategic planning, a well oriented diet, and strict Lifestyle changes. All these things combined together will help to keep the Cervical Spondylosis at Bay.However in certain cases despite taking best possible precautions the Cervical Spondylosis may progress to a point where it would inevitably need a surgical intervention.

The cervical spine surgery nowadays and become very very safe thanks to the availability of endoscopes and microscopes. They give prompt and significant relief to the patient which is generally very much predictable in nature.

Most of the Best Spine Surgeons in India are well versed with using spinal endoscopes & microscopes.