Cervical Spondylosis - Myths and Facts

Cervical Spondylosis, as we Orthopaedicians describe, is the degenerative change in the Cervical spine vertebrae often presenting on X-ray film as excess bone formation at the vertebral body margins, due to a chronic degenerative pathology. So, a young patient with acute onset neck pain, being diagnosed as Cervical Spondylosis is a Misnomer.

An X-ray film of the Neck is a good basic test to diagnose Cervical spondylosis. It often presents with Chronic, dull aching pain which aggravates with extremes of movement. Using a collar provides more psychological reassurance, than actually treating the pathology. A soft/ hard collar is more effective in treating acute muscle spasms of the neck usually precipitated by some injury or an acute disc prolapse. In such cases, we suggest restriction of neck movements to prevent further injury.

Two more synonymous terms that need a mention are- Spondylitis, and Spondylolisthesis. The former is an inflammation of the spinous processes of the vertebra, while the latter suggests abnormal translation of one vertebra over another leading to a loss of sagittal balance.

The preferred treatment for a Cervical Spondylosis is supervised physiotherapy. Gentle stretching exercises along with Isometric exercises of the neck help in improving the muscle tone of para-vertebral muscles. Heat therapy in the form of Interferential therapy (IFT) and Ultrasonic therapy also help relieve the symptoms.

Patients with long- standing symptoms often develop multiple level disc bulges with dessication (dryness of disc), as evident on the MRI. If severe, it may produce compression on the exiting nerve root and produce tingling and numbness in the upper limbs.

Surgical treatment is suitable to those with single or two level disc bulges, wherein a fusion of the vertebrae may be performed with or without instrumentation.

Cervical disc replacement is a novel treatment offered to those with single level disc prolapse, and without excessive facet joint arthritis. It offers reasonable movement at the vertebral interface, and is better tolerated by the younger active population.