Cervical Spondylosis

Cervical Spondylosis

Cervical spondylosis is a disorder that causes long term neck pain usually among old aged individuals as a result of tear in neck structures due to aging. ^[1]

Epidemiology

In some studies done, it has been found out that males are affected earlier. ^[2] Majority of people with age greater than 65 have radiographic evidences of the disorder as seen in X-ray films even those who do not experience any symptom. ^[1]

Causes

Cervical spondylosis mainly arises due to degeneration of structures that make up the cervical spine including the spinal disks. As one ages, the disks lose water and in due course shrink. In addition, abnormal growths or spurs may arise which leads to narrowing followed by a buildup of consequential pressure on the area affected. ^{[2] [3]}

 Risk factors identified include obesity, past spinal injury or surgical operation and doing work that involves forceful lifting or neck twisting. ^[3] The disease can run in families and a person who smokes may be more susceptible. Patients who have cerebral palsy and Down syndrome also have increased likelihood to be affected.

Signs and Symptoms

A person often experiences neck stiffness and pain that can be aggravated by sneezing, coughing or by doing some neck movements. Other manifestations of the disorder include changes or loss of sensation in arms up to shoulders, loss of body coordination, weakness, headache and urination or defecation difficulty. ^{[3] [4]}

Diagnosis

History taking and physical examination are important for the physician to suspect cervical spondylosis. Imaging studies are often requested with MRI as the mostly preferred exam. CT scan is also another choice as it offers good visualization of the bones. Plain film can also be done as it is relatively more inexpensive and readily available than MRI and CT scan. Spinal root lesions can be studied by a test called4 myelography. ^[2]

Treatment

The symptoms may resolve spontaneously. Pain can be managed by Nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin or if it is severe enough, narcotics or opioids can be given. The patient may also be referred to a physical therapist. ^[3] Lifestyle modifications are taught to affected individuals. These involve postural awareness and education about body mechanics. Modifications in the workplace help especially if occupation seems to be a factor. Depending on the case, surgery may be an option. ^[2]

References:

1.      http://www.mayoclinic.com/health/cervical-spondylosis/DS00697

2.       http://emedicine.medscape.com/article/1144952-overview#a0199

3.      http://www.nlm.nih.gov/medlineplus/ency/article/000436.htm

4.      http://www.nhs.uk/Conditions/Cervical-spondylosis/Pages/Introduction.aspx

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