Cervical spondylosis is a very common, cervical spondylosis disease in which the joints, discs, soft tissues and muscles of the cervical spine are affected due to age, occupational and sports strains, and posture disorders. It is generally seen in people over the age of 40 and its frequency and severity increases with age. It is a disease also known as osteoarthritis. It is especially seen in the areas where the neck (cervical) vertebrae are most mobile (C4-C5, C5-C6, C6-C7).
Cervical spondylosis is very common and increases with age. Although there is a known genetic predisposition, such changes occur more frequently in some families over time.
Cervical spondylosis and osteoarthritis are detected on neck X-ray in more than 90% of people over the age of 65. However, most of these people do not have any complaints.
Although it affects both genders, it occurs at an earlier age in men than in women. As a person ages, the bones and cartilages that make up the back and neck spine are subject to progressive degeneration and wear-and-tear (degeneration), resulting in the formation of bony protrusions called osteophytes. Not every patient with cervical spondylosis and osteophytes experiences pain. Sometimes, mild spondylosis causes very severe pain, while a more severe osteoarthritis or spondylosis may present with milder symptoms or may not even cause any complaints.
Although this finding is detected in the radiological imaging examinations of many people, most of the time it does not have a clinical manifestation. It doesn't matter. In cervical spondylosis, one or more of the nerves coming from the cervical spinal cord are under pressure, causing a condition called radiculopathy (nerve root compression). Bone protrusions called osteophytes can compress the spinal cord by causing narrowing of the spinal canal. As a result, spinal cord injury called cervical myelopathy may occur. Traumas such as falling from a height, traffic accidents, or jumping into water can suddenly increase spinal cord injury in cases of cervical spondylosis that have not shown any symptoms until that moment. The cause of pain in cervical spondylosis is; It is the pressure of osteophytes, degenerated or ruptured discs on the surrounding nerves and soft tissues. Spasm in the neck muscles, shortening, hypoxic changes in the muscles, ligament classifications and calf Contractions, disorders in the cervical axis, stress, postural disorders and trauma are the most important factors in the emergence of pain.
What happens in cervical spondylosis?
-A tense and painful neck, limitation of movement
-Fatigue, depressive symptoms, visual acuity loss
-Headaches
-Shoulder and arm pain, shortening of the muscles around the shoulder in long-lasting pains.
-Numbness and tingling in the arms, hands, legs and feet
- Weakness in arms and hands; If there is myelopathy, weakness in the legs and feet
-Loss of coordination and clumsiness in the hands
-Difficulty in walking (in myelopathy)
-Abnormal deep tendon reflexes, loss of reflexes in the upper extremities, increase in the lower ones (in myelopathy)
-Urination and fecal incontinence or retention (in myelopathy)
How is the diagnosis made?
The diagnosis of the disease is made after complaints and history are taken. It is determined with the help of examination and radiological imaging methods that will be requested accordingly. In order to understand whether the spinal cord and nerve roots are under pressure, reflexes, muscle strength and sensory examinations of the arms and legs must be performed. Cervical spondylosis can also cause restriction of neck movements, which can be detected on examination. Cervical direct radiography and cervical magnetic resonance (MRI) may be requested as imaging examinations, and diagnosis can be made by detecting bone protrusions, pressure on the spinal cord and nerve roots, or herniations in the discs between the vertebrae. EMG can be performed to evaluate the condition of the nerves.
How should the treatment be done?
-Wearing a neck brace restricts neck movements and reduces nerve irritation
-Special corsets for cervical axis disorder if there is a disorder
-Drugs
-Exercises to strengthen neck muscles and increase range of motion
-IMS applications for paravertebral muscles make most patients asymptomatic
-Prolotherapy injections if there is ligamentary damage
-Corticosteroid and local anesthetic injection into the joints (facet joints) between the vertebrae
-Ergonomic interventions, orthopedic pillows
Surgical Treatment, surgical intervention should be avoided as much as possible. If conservative medical treatments do not work, the patient's neck pain persists, or neurological findings worsen, surgical intervention is considered. The surgical intervention to be performed varies depending on the pathology causing the patient's current condition.
Read: 0
