440:, 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.
560:(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.
433:(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.
52:
328:, 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.
460:
552:(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
486:
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,
339:
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.
519:
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
523:
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
532:
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
487:
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
494:
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
1173:
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
510:
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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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.
264:, 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
161:
520:
cervical spondylosis with myelopathy (CSM) remain somewhat controversial, but "most clinicians recommend operative therapy over conservative therapy for moderate-to-severe myelopathy".
201:, 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
293:
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
393:, 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.
340:
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.
536:
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
405:. 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
573:: Performed when there is evidence of spinal instability or mal-alignment. Use of instrumentation (such as pedicle screws) in fusion surgeries varies across studies.
474:. 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
344:
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
260:, 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
524:
that strong compliance with postural modification is necessary to realize maximum benefit from decompression, adjustments and flexibility rehabilitation.
499:
of the spine. However, interverterbral foramen and ligaments are not well visualised on the CT. Therefore, contrast is injected into the spinal canal via
671:
Takagi I, Eliyas JK, Stadlan N (October 2011). "Cervical spondylosis: an update on pathophysiology, clinical manifestation, and management strategies".
309:(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.
335:, 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.
883:
Denis DJ, Shedid D, Shehadeh M, Weil AG, Lanthier S (May 2014). "Cervical spondylosis: a rare and curable cause of vertebrobasilar insufficiency".
320:, 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
507:). 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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1125:"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
27:(partly overlapping in the broader of the two senses of "spondylosis"),
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556:(removal of lamina with a bone graft or metal plate as replacement) or
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949:"Current Diagnosis and Management of Cervical Spondylotic Myelopathy"
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1275:"Lumbar spondylosis: clinical presentation and treatment approaches"
836:"Lumbar spondylosis: clinical presentation and treatment approaches"
51:
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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
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804:"Les Formes douloureuses de la Commotion de la Moelle épiniére"
353:
478:), explaining the symptoms. There is also spondylosis of the
218:
197:
from any cause. In the more narrow sense it refers to spinal
544:(joining two or more vertebrae together), anterior cervical
368:(abnormal abduction of little finger) can also be elicited.
256:(sensory and motor disturbances, such as severe pain in the
257:
230:
816:(3). Société Française de Neurologie: 257–262 – via
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268:. If vertebrae of the neck are involved it is labelled
1074:
Gibson JN, Waddell G (October 2005). Gibson JN (ed.).
280:, "a vertebra", in plural "vertebrae – the backbone".
276:
spondylosis. The term is from
Ancient Greek σπόνδυλος
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548:(removal of vertebral body) and fusion, and cervical
1323:
946:
947:Bakhsheshian J, Mehta VA, Liu JC (September 2017).
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806:[Painful Forms of Spinal Cord Concussion].
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601:Carette, Simon; Fehlings, Michael G. (2005-07-28).
76:. Unsourced material may be challenged and removed.
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1129:Journal of Neurology, Neurosurgery, and Psychiatry
750:Caridi JM, Pumberger M, Hughes AP (October 2011).
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401:A rare but severe complication of this disease is
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272:spondylosis. Lower back spondylosis is labeled
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1076:"Surgery for degenerative lumbar spondylosis"
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1279:Current Reviews in Musculoskeletal Medicine
1080:The Cochrane Database of Systematic Reviews
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840:Current Reviews in Musculoskeletal Medicine
603:"Clinical practice. Cervical radiculopathy"
503:and then imaged using CT scan (known as CT
451:all can also cause spinal canal narrowing.
213:). If severe, it may cause pressure on the
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312:In cervical radiculopathy, there would be
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540:(removal of the intervertebral disc) and
491:(slippage of one vertebra over another).
136:Learn how and when to remove this message
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1004:
447:, facet joints, and its capsules, and
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1203:Taber's Cyclopedic Medical Dictionary
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371:
283:
1007:"Cervical spondylosis and neck pain"
74:adding citations to reliable sources
45:
16:Degeneration of the vertebral column
709:McCormack BM, Weinstein PR (1996).
607:The New England Journal of Medicine
13:
1486:
1273:Middleton K, Fish DE (June 2009).
1182:
834:Middleton K, Fish DE (June 2009).
752:"Cervical radiculopathy: a review"
14:
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711:"Cervical spondylosis. An update"
396:
50:
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715:The Western Journal of Medicine
685:10.1016/j.disamonth.2011.08.024
297:(due to compression of exiting
61:needs additional citations for
1092:10.1002/14651858.CD001352.pub3
989:
594:
1:
1123:Malcolm GP (September 2002).
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403:vertebrobasilar insufficiency
1700:Intervertebral disc disorder
514:
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7:
1142:10.1136/jnnp.73.suppl_1.i34
1023:10.1136/bmj.39127.608299.80
995:Newman & Santiago, 2013
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193:is the degeneration of the
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1749:Vertebral column disorders
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18:
1713:Degenerative disc disease
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1292:10.1007/s12178-009-9051-x
897:10.1007/s00586-013-2983-2
852:10.1007/s12178-009-9051-x
768:10.1007/s11420-011-9218-z
466:of a man presenting with
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364:(Babinski response), and
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1005:Binder AI (March 2007).
965:10.1177/2192568217699208
472:cervical spinal nerve 7
413:may cause stenosis for
391:neurogenic claudication
1718:Spinal disc herniation
1576:Ankylosing spondylitis
1199:. In Thomas CL (ed.).
885:European Spine Journal
564:Decompression surgery:
483:
303:intervertebral foramen
229:disturbances, such as
1723:Facet joint arthrosis
1537:Scheuermann's disease
462:
360:, upward response of
1135:(Suppl 1): i34–i41.
953:Global Spine Journal
891:(Suppl 2): 206–213.
619:10.1056/NEJMcp043887
443:Degeneration of the
289:Cervical spondylosis
168:Thoracic spondylosis
70:improve this article
1209:F. A. Davis Company
445:intervertebral disc
29:spondyloarthropathy
1744:Skeletal disorders
1409:External resources
809:Revue neurologique
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372:Lumbar spondylosis
284:Signs and symptoms
266:lack of blood flow
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1624:Spondylolisthesis
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1207:(15th ed.).
1017:(7592): 527–531.
489:spondylolisthesis
449:ligamentum flavum
417:, manifesting as
366:Wartenberg's sign
358:Hoffmann's reflex
188:
187:
148:Medical condition
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37:spondylolisthesis
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1607:non inflammatory
1593:Spondylodiscitis
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802:(4 March 1920).
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1668:Upper back pain
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1183:Further reading
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1086:(4): CD001352.
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679:(10): 583–591.
673:Disease-a-Month
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501:lumbar puncture
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381:formation, and
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243:muscle weakness
203:neural foramina
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762:(3): 265–272.
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613:(4): 392–399.
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571:Fusion surgery
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362:plantar reflex
342:Lhermitte sign
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245:in the limbs.
211:facet syndrome
199:osteoarthritis
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68:Please help
63:verification
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1614:Spondylosis
1571:Spondylitis
1542:Torticollis
1445:Spondylosis
1418:MedlinePlus
756:HSS Journal
583:Laminectomy
558:laminectomy
505:myelography
480:facet joint
476:axial plane
438:subluxation
411:osteophytes
383:hypertrophy
250:spinal cord
235:paresthesia
219:nerve roots
215:spinal cord
191:Spondylosis
183:Orthopedics
154:Spondylosis
126:August 2014
25:spondylitis
1738:Categories
1678:Coccydynia
1440:Patient UK
1394:DiseasesDB
1260:20 October
1211:. p.
589:References
546:corpectomy
538:discectomy
379:osteophyte
346:spasticity
333:myelopathy
307:myelopathy
262:myelopathy
96:newspapers
1663:Neck pain
1655:Back pain
1521:Scoliosis
1495:Deforming
1434:neuro/564
1429:eMedicine
1255:24221204M
1231:1065-1357
1193:(1985) .
1151:1468-330X
1061:Baron ME
905:1432-0932
627:1533-4406
515:Treatment
455:Diagnosis
337:Iliopsoas
278:spóndylos
239:imbalance
174:Specialty
1683:Sciatica
1588:Discitis
1516:Lordosis
1511:Kyphosis
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577:See also
431:pedicles
352:or even
318:tingling
314:numbness
270:cervical
205:and the
19:Compare
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305:) or
227:motor
117:JSTOR
103:books
1383:MeSH
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1361:9-CM
1307:PMID
1262:2022
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1217:ISBN
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623:ISSN
258:neck
231:pain
89:news
1366:721
1357:ICD
1351:M47
1342:ICD
1297:PMC
1287:doi
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