Spondylosis

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Spondylosis
ICD-10 M47.
ICD-9 721

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Not to be confused with spondylitis, spondylolysis or spondylolisthesis.

Overview

Spondylosis is spinal degeneration and deformity of the joint(s) of two or more vertebrae that commonly occurs with aging. Often there is herniation of the nucleus pulposus of one or more intervertebral discs and/or formation of osteophytes.

When the space between two adjacent vertebrae narrows, compression of a nerve root emerging from the spinal cord may result in sensory system and motor system disturbances, such as severe pain in the neck, shoulder, arm, back, and/or leg, accompanied by muscular weakness. Less commonly, direct pressure on the spinal cord may result in global weakness, gait dysfunction, loss of balance, and loss of bowel and/or bladder control. The patient may experience a phenomenon of shocks in hands and legs because of nerves contraction and lack of blood flow. If vertebrae of the neck are involved it is labeled Cervical Spondylosis. Lower back spondylosis is labeled Lumbar Spondylosis.

Treatment

Neck pain can be relieved by wearing a hard collar around the neck which keeps the affected vertebrae slightly apart, and hence the pressure on the nerves is released. However, the use of a collar is not usually recommended as it can weaken the muscles supporting the vertebrae and hence exacerbate the problem in the long term.

Chiropractic treatment of this condition is often successful. Symptoms are often reduced or eliminated without the need for drugs or surgery. Among skilled practitioners, there is frequently an improvement in the alignment of the spine which reduces the inflammation and irritation of the spinal nerves. Most people who are aware of the benefits of chiropractic care prefer this conservative approach to the more radical approach of surgery.

Physiotherapy and Massage Therapy treatments focus on neck exercises and soft tissue balancing, and is now generally used as the preferred treatment. Symptomatic relief can be managed, but is limited in the presence of bony deformities.

Acupuncture, while often effective when neuropathy results from muscle dysfunction or inflammation, symptoms resulting from bony deformities are unlikely to get better.

Injections of the spinal joints can be useful for relief of acute pain for otherwise intractable discomfort. Naturally, any spine injection should be performed by a physician with training in spine injection techniques. These injections should be done with x-ray assistance (flouroscopy) to ensure accuracy.

Evidential support for mobility (physiotherapy) or manipulative (chiropractic) therapies has shown an observed improvement in perceived pain and immobility in mechanical neck disorders. However such therapies are not supported as being of greater use in relieving pain and inflammation than conventional medicine and neither was identified as being superior to the other.

Surgery

There are many different surgical procedures to correct spinal deformity. The vertebra can be approached by the surgeon from the front, side, or rear. Portions of a disc may be removed. To prevent further dislocation, fusion of two vertebrae may be done by taking pieces of bone from the patient's hip and inserting them between the two vertebrae which are fused together and secured by screws.

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