451:, stress induced by sports, acute and/or repetitive trauma, or poor posture, being placed on the vertebrae and the discs between them. The abnormal stress causes the body to form new bone in order to compensate for the new weight distribution. This abnormal weight bearing from bone displacement will cause spondylosis to occur. Poor postures and loss of the normal spinal curves can lead to spondylosis as well. Spondylosis can affect a person at any age; however, older people are more susceptible.
571:(removal of lamina without any replacement) with or without fusion can be used for decompression. The posterior approach is also used when the source of compression arises from the posterior part of the spinal canal. The posterior approach also avoids some technical challenges associated with the anterior approach, such as obesity, short neck, barrel chest, or previous anterior neck surgery. If three or more spinal segments are involved, both anterior and posterior approaches are used.
444:(that form the vertebral arch). When the spinal canal diameter divided by vertebral body diameter is less than 0.82, or the anteroposterior diameter of the spinal canal is less than 1.3cm or the distance between the pedicles is less than 2.3cm during imaging, cervical spine stenosis is diagnosed symptoms correlate well with the spinal canal narrowings. This is because some patients may not have any symptoms at all even when there is severe cervical spine spondylosis.
63:
339:, which take advantage of this phenomenon, is performed by extending and laterally flexing the patient's head and placing downward pressure on it to narrow the intervertebral foramen. Neck or shoulder pain on the ipsilateral side (i.e., the side to which the head is flexed) indicates a positive result for this test. A positive test result is not necessarily a positive result for spondylosis and as such additional testing is required.
471:
563:(joint surgery) can be used to relieve the spinal cord from compression. The anterior approach is also preferred when the source of compression arises from the anterior part of the cervical canal. If the cervical spine is in a fixed kyphotic position and with one to two involved spinal segments, posterior approaches such as
497:
Those with neck pain only without any positive neurological findings usually do not require an x-ray of the cervical spine. For those with chronic neck pain, a cervical spine x-ray may be indicated. There are various ways of doing cervical spine X-rays such as anteroposterior (AP) view, lateral view,
350:
muscle is the first group of muscles that is affected. Lower limb weaknesses without any upper limb involvement should raise the suspicion of thoracic cord compression. Finger escape sign is performed to detect the weakness of the fingers. A person's forearm is pronated and the fingers are extended.
530:
Many of the treatments for cervical spondylosis have not been subjected to rigorous, controlled trials. Surgery is advocated for cervical radiculopathy in patients who have intractable pain, progressive symptoms, or weakness that fails to improve with conservative therapy. Surgical indications for
534:
Physical therapy may be effective for restoring range of motion, flexibility and core strengthening. Decompressive therapies (i.e., manual mobilization, mechanical traction) may also help alleviate pain. However, physical therapy and osteopathy cannot "cure" the degeneration, and some people view
543:
Current surgical procedures used to treat spondylosis aim to alleviate the signs and symptoms of the disease by decreasing pressure in the spinal canal (decompression surgery) and/or by controlling spine movement (fusion surgery) but the evidence is limited in support of some aspects of these
498:
Swimmer's view, and oblique view. Cervical X-rays may show osteophytes, decreased intervertebral disc height, narrowing of the spinal canal, and abnormal alignment (kyphosis of the cervical spine). Flexion and extension view of the cervical spine is helpful to look for
505:
MRI and CT scans are helpful for diagnosis but generally are not definitive and must be considered together with physical examinations and history. CT scan is helpful to see small bony elements of the spine such as facet joint and to determine whether there is
1184:
Cervical discs or osteophytes indenting the cord anteriorly will therefore be removed by anterior cervical discectomy, whereas a narrow cervical canal secondary to hypertrophied posterior ligaments or a congenitally narrow canal will be treated by a posterior
521:
MRI is the investigation of choice to investigate radiculopathy and myelopathy. MRI can show intervertebral foramen, spinal canal, ligaments, degree of disc degeneration or herniation, alignment of the spine, and changes on the spinal cord accurately.
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The vertebral column can be operated on from both an anterior and posterior approach. The approach varies depending on the site and cause of root compression. Commonly, osteophytes and portions of intervertebral disc are removed.
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Since the spinal cord ends at L1 or L2 vertebral levels, the job of nerve transmission is continued by spinal nerves for the remaining part of the vertebral canal. Degenerative process of spondylosis such as disc bulging,
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1352:
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of the superior articular process all contributes to the narrowing of the spinal canal and intervertebral foramen, leading to compression of these spinal nerves that results in radiculopathy-related symptoms.
275:, characterized by global weakness, gait dysfunction, loss of balance, and loss of bowel or bladder control. The patient may experience shocks (paresthesia) in hands and legs because of nerve compression and
172:
531:
cervical spondylosis with myelopathy (CSM) remain somewhat controversial, but "most clinicians recommend operative therapy over conservative therapy for moderate-to-severe myelopathy".
212:, the age-related degeneration of the spinal column, which is the most common cause of spondylosis. The degenerative process in osteoarthritis chiefly affects the vertebral bodies, the
304:
In cervical spondylosis, a patient may be presented with dull neck pain with neck stiffness in the initial stages of the disease. As the disease progresses, symptoms related to
404:, characterised by symptoms such as lower back pain, leg pain, leg numbness, and leg weakness that worsens with standing and walking and improves with sitting and lying down.
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If the person has myelopathy, there will be slow abduction and flexion of the fingers on the ulnar side. The degree of loss of sensation may be different on both upper limbs.
547:
In cervical myelopathy, if the spine still retains its neutral or lordotic alignment, with one or two involved spinal segments, anterior approaches such as anterior cervical
416:. This is a result of the vertebral artery becoming occluded as it passes up in the transverse foramen. The spinal joints become stiff in cervical spondylosis. Thus the
584:: Performed when there is evidence of spinal instability or mal-alignment. Use of instrumentation (such as pedicle screws) in fusion surgeries varies across studies.
485:. It shows spondylosis with osteophytes between the vertebral bodies C6 and C7 on the left side, causing foraminal stenosis at this level (lower arrow, also showing
355:
is performed by asking a person to gently extend the neck. Those with cervical myelopathy will produce a feeling of electrical shock down the spine or arms. Muscle
271:, shoulder, arm, back, or leg, accompanied by muscle weakness). Less commonly, direct pressure on the spinal cord (typically in the cervical spine) may result in
535:
that strong compliance with postural modification is necessary to realize maximum benefit from decompression, adjustments and flexibility rehabilitation.
510:
of the spine. However, interverterbral foramen and ligaments are not well visualised on the CT. Therefore, contrast is injected into the spinal canal via
682:
Takagi I, Eliyas JK, Stadlan N (October 2011). "Cervical spondylosis: an update on pathophysiology, clinical manifestation, and management strategies".
320:(due to compression on the spinal cord) can occur. Reduced range of motion of the neck is the most frequent objective finding on physical examination.
346:, almost always involves both the upper and lower limbs. A person may experience difficult gait or limb stiffness in the early stages of the disease.
894:
Denis DJ, Shedid D, Shehadeh M, Weil AG, Lanthier S (May 2014). "Cervical spondylosis: a rare and curable cause of vertebrobasilar insufficiency".
331:, or burning pain at the skin area supplied by the spinal nerve, shooting pain along the course of the spinal nerve, or weakness or absent
518:). CT myelography is useful when the person is contraindicated to MRI scan due to presence of pacemaker or infusion pump in the body.
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between C2 and C3, with some foraminal stenosis at this level (upper arrow), which appears to be asymptomatic.
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When the space between two adjacent vertebrae narrows, compression of a nerve root emerging from the
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of the muscle supplied by the nerve. This symptom can be provoked by neck extension. Therefore,
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1136:"Surgical disorders of the cervical spine: presentation and management of common disorders"
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Spondylosis is caused from years of constant abnormal pressure, caused by joint
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Narrowing of the lumbar spinal canal causes a clinical condition known as
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which maintain the disc become deprived of nutrition and die. Secondary
38:(partly overlapping in the broader of the two senses of "spondylosis"),
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1450:
567:(removal of lamina with a bone graft or metal plate as replacement) or
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548:
421:
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343:
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171:
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960:"Current Diagnosis and Management of Cervical Spondylotic Myelopathy"
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1286:"Lumbar spondylosis: clinical presentation and treatment approaches"
847:"Lumbar spondylosis: clinical presentation and treatment approaches"
62:
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are characteristic of myelopathy. Other abnormal reflexes such as
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Congenital cervical spine stenosis commonly occurs due to short
1356:
815:"Les Formes douloureuses de la Commotion de la Moelle épiniére"
364:
489:), explaining the symptoms. There is also spondylosis of the
229:
208:
from any cause. In the more narrow sense it refers to spinal
555:(joining two or more vertebrae together), anterior cervical
379:(abnormal abduction of little finger) can also be elicited.
267:(sensory and motor disturbances, such as severe pain in the
268:
241:
827:(3). Société Française de Neurologie: 257–262 – via
893:
279:. If vertebrae of the neck are involved it is labelled
1085:
Gibson JN, Waddell G (October 2005). Gibson JN (ed.).
291:, "a vertebra", in plural "vertebrae – the backbone".
287:
spondylosis. The term is from
Ancient Greek σπόνδυλος
760:
559:(removal of vertebral body) and fusion, and cervical
1334:
957:
958:Bakhsheshian J, Mehta VA, Liu JC (September 2017).
953:
951:
949:
817:[Painful Forms of Spinal Cord Concussion].
681:
612:Carette, Simon; Fehlings, Michael G. (2005-07-28).
87:. Unsourced material may be challenged and removed.
1211:
1205:
1140:Journal of Neurology, Neurosurgery, and Psychiatry
761:Caridi JM, Pumberger M, Hughes AP (October 2011).
719:
412:A rare but severe complication of this disease is
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283:spondylosis. Lower back spondylosis is labeled
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677:
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1283:
1087:"Surgery for degenerative lumbar spondylosis"
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1290:Current Reviews in Musculoskeletal Medicine
1091:The Cochrane Database of Systematic Reviews
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851:Current Reviews in Musculoskeletal Medicine
614:"Clinical practice. Cervical radiculopathy"
514:and then imaged using CT scan (known as CT
462:all can also cause spinal canal narrowing.
224:). If severe, it may cause pressure on the
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323:In cervical radiculopathy, there would be
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551:(removal of the intervertebral disc) and
502:(slippage of one vertebra over another).
147:Learn how and when to remove this message
469:
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14:
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1015:
458:, facet joints, and its capsules, and
1471:
1214:Taber's Cyclopedic Medical Dictionary
1200:
382:
294:
1018:"Cervical spondylosis and neck pain"
85:adding citations to reliable sources
56:
27:Degeneration of the vertebral column
720:McCormack BM, Weinstein PR (1996).
618:The New England Journal of Medicine
24:
1497:
1284:Middleton K, Fish DE (June 2009).
1193:
845:Middleton K, Fish DE (June 2009).
763:"Cervical radiculopathy: a review"
25:
1771:
1330:
722:"Cervical spondylosis. An update"
407:
61:
1127:
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726:The Western Journal of Medicine
696:10.1016/j.disamonth.2011.08.024
308:(due to compression of exiting
72:needs additional citations for
1103:10.1002/14651858.CD001352.pub3
1000:
605:
13:
1:
1134:Malcolm GP (September 2002).
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414:vertebrobasilar insufficiency
1711:Intervertebral disc disorder
525:
465:
7:
1153:10.1136/jnnp.73.suppl_1.i34
1034:10.1136/bmj.39127.608299.80
1006:Newman & Santiago, 2013
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204:is the degeneration of the
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1760:Vertebral column disorders
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29:
1724:Degenerative disc disease
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1303:10.1007/s12178-009-9051-x
908:10.1007/s00586-013-2983-2
863:10.1007/s12178-009-9051-x
779:10.1007/s11420-011-9218-z
477:of a man presenting with
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375:(Babinski response), and
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169:
164:
1016:Binder AI (March 2007).
976:10.1177/2192568217699208
483:cervical spinal nerve 7
424:may cause stenosis for
402:neurogenic claudication
1729:Spinal disc herniation
1587:Ankylosing spondylitis
1210:. In Thomas CL (ed.).
896:European Spine Journal
575:Decompression surgery:
494:
314:intervertebral foramen
240:disturbances, such as
1734:Facet joint arthrosis
1548:Scheuermann's disease
473:
371:, upward response of
1146:(Suppl 1): i34–i41.
964:Global Spine Journal
902:(Suppl 2): 206–213.
630:10.1056/NEJMcp043887
454:Degeneration of the
300:Cervical spondylosis
179:Thoracic spondylosis
81:improve this article
18:Cervical spondylosis
1220:F. A. Davis Company
456:intervertebral disc
40:spondyloarthropathy
1755:Skeletal disorders
1420:External resources
820:Revue neurologique
495:
383:Lumbar spondylosis
295:Signs and symptoms
277:lack of blood flow
1742:
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1635:Spondylolisthesis
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1218:(15th ed.).
1028:(7592): 527–531.
500:spondylolisthesis
460:ligamentum flavum
428:, manifesting as
377:Wartenberg's sign
369:Hoffmann's reflex
199:
198:
159:Medical condition
157:
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48:spondylolisthesis
16:(Redirected from
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1618:non inflammatory
1604:Spondylodiscitis
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1514:Spinal curvature
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1207:"Vocabulary - S"
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813:(4 March 1920).
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1679:Upper back pain
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1647:Spinal stenosis
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1194:Further reading
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1097:(4): CD001352.
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690:(10): 583–591.
684:Disease-a-Month
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653:
610:
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602:
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541:
528:
512:lumbar puncture
468:
438:
410:
392:formation, and
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337:Spurling's test
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254:muscle weakness
214:neural foramina
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1640:Retrolisthesis
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1609:Pott's disease
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1499:Spinal disease
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582:Fusion surgery
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353:Lhermitte sign
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256:in the limbs.
222:facet syndrome
210:osteoarthritis
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44:spondylolysis
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79:Please help
74:verification
71:
1625:Spondylosis
1582:Spondylitis
1553:Torticollis
1456:Spondylosis
1429:MedlinePlus
767:HSS Journal
594:Laminectomy
569:laminectomy
516:myelography
491:facet joint
487:axial plane
449:subluxation
422:osteophytes
394:hypertrophy
261:spinal cord
246:paresthesia
230:nerve roots
226:spinal cord
202:Spondylosis
194:Orthopedics
165:Spondylosis
137:August 2014
36:spondylitis
1749:Categories
1689:Coccydynia
1451:Patient UK
1405:DiseasesDB
1271:20 October
1222:. p.
600:References
557:corpectomy
549:discectomy
390:osteophyte
357:spasticity
344:myelopathy
318:myelopathy
273:myelopathy
107:newspapers
1674:Neck pain
1666:Back pain
1532:Scoliosis
1506:Deforming
1445:neuro/564
1440:eMedicine
1266:24221204M
1242:1065-1357
1204:(1985) .
1162:1468-330X
1072:Baron ME
916:1432-0932
638:1533-4406
526:Treatment
466:Diagnosis
348:Iliopsoas
289:spóndylos
250:imbalance
185:Specialty
1694:Sciatica
1599:Discitis
1527:Lordosis
1522:Kyphosis
1322:19468872
1258:10403099
1250:62008364
1202:Taber CW
1180:12185260
1121:16235281
1060:17347239
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881:19468872
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646:16049211
588:See also
442:pedicles
363:or even
329:tingling
325:numbness
281:cervical
216:and the
30:Compare
1399:D013128
1313:2697338
1171:1765596
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940:1552821
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539:Surgery
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1541:Other
1410:12323
1158:eISSN
1038:JSTOR
936:S2CID
912:eISSN
316:) or
238:motor
128:JSTOR
114:books
1394:MeSH
1383:OMIM
1372:9-CM
1318:PMID
1273:2022
1254:OCLC
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1238:ISSN
1228:ISBN
1224:1609
1176:PMID
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700:PMID
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634:ISSN
269:neck
242:pain
100:news
1377:721
1368:ICD
1362:M47
1353:ICD
1308:PMC
1298:doi
1166:PMC
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