Cervical spondylosis

What is cervical spondylosis?

Cervical spondylosis is a degenerative condition of the cervical spine. It involves changes to the bones, discs and joints of the neck. These changes are caused by the normal wear-and-tear of ageing. As it progresses with age, the discs of the cervical spine gradually break down, lose fluid and become stiffer. Cervical spondylosis usually occurs in middle-aged and elderly people.

The NHS says changes of spondylosis can be found in 85% of people over the age of 60. Men usually develop it earlier than women.

In addition to the breakdown of vertebrae, which are the individual bones in the spine, spurs or abnormal growths called osteophytes may form on the bones in the neck. These abnormal growths can cause narrowing of the interior of the spinal column, a related condition called cervical stenosis, which leads to pressure on the delicate spinal cord in this area.

Cervical spondylosis most often causes neck pain and stiffness. Although cervical spondylosis is rarely progressive, corrective surgery can be helpful in severe cases.

What are the risk factors for cervical spondylosis?

Ageing is the major factor for developing cervical spondylosis. In most people 50 years old, the discs between the vertebrae become less spongy and provide less of a cushion. Bones and ligaments get thicker, encroaching on the space of the spinal canal.

Another factor might be a previous injury to the neck. People in certain occupations or who perform specific activities such as gymnasts or other athletes may put more stress on their necks.

Poor posture might also play a role in the development of spinal changes that result in cervical spondylosis.

What are the symptoms of cervical spondylosis?

The symptoms of cervical spondylosis include:

• Neck stiffness and pain
• Headache that may originate in the neck
• Pain in the shoulder, arms or chest
• Grinding noise or sensation when the neck is turned

Symptoms of cervical spondylosis tend to improve with rest. Symptoms are most severe in the morning and again at the end of the day.

If cervical spondylosis results in pressure on the spinal cord (cervical stenosis), it can damage nerves, a condition called cervical myelopathy. Symptoms of cervical spondylosis with myelopathy include:

• Tingling, numbness and/or weakness in the arms, hands, legs or feet
• Lack of coordination and difficulty walking
• Abnormal reflexes
• Muscle spasms

Another possible complication of cervical spondylosis is cervical radiculopathy, when changes in bone structure, for example formation of bone spurs, causes pressure on nerves as they exit the bones of the spinal column. Pain shooting down into one or both arms is the most common symptom.

How is cervical spondylosis diagnosed?

Your doctor will generally begin by asking you about your symptoms and looking at your medical history. This will be followed by a physical examination of the body, with a focus on the neck, back and shoulders to find sore spots. The doctor is also likely to test reflexes and watch you walk. An abnormal gait caused by difficulty walking is one of the symptoms.

Other tests that might be done include imaging exams such as X-rays, computerised tomography (CT) and magnetic resonance imaging (MRI) of the spine. MRI scans use large magnets, radio waves and a computer to produce the best images of the body. You might also be referred to a neurologist.