CERVICAL SPONDYLOSIS basically is a term used to signify significant
age related or degenerative
changes of the neck or cervical spine. Indeed cervical spondylosis can be considered
a disease with degenerative changes affecting the vertebrae of the cervical spine
and the associated connective tissue including the ligaments and connective
tissue surrounding the facet joints and the discs between the vertebrae. The
effects of mechanical strain over time
and natural wear and tear effects of aging can cause the slow degenerative changes
of the cervical spine or neck vertebrae with resulting cervical spondylosis. Trauma
is another additive effect which may adversely affect the spine or nerve roots
and even alter the structure of cervical spine. The same effect on the lower back can occur causing lumbar spondylosis.
The MRI shown below reveals central spinal canal stenosis with degenerative disc structural changes present causing compression of the anterior spinal cord . This degree of spinal cord compression with underlying spinal cord deformity can cause myelopathy or impairment of the neurological function of the spinal cord.
Many symptoms can be observed often as in a similar pattern. Certain neck positions can reproduce or even relieve the symptoms. Neck pain only can occur , and pain can be felt in the shoulder blade or scapular area of the trunk. Pain may be referred or felt in the shoulder blade or surrounding muscles from inflammation or injury to the cervical spine facet joint or disc. Neck movements can be restricted and stiffness of the neck may be felt. If the spinal cord or a nerve root become irritated or compressed then neurologic effects on the shoulder and arm may result. The patient may feel pain along the nerve root branches in the arm or symptoms may include numbness or tingling or loss of ability to feel properly with the fingers. Weakness and atrophy of the muscle may occur. The patient may have changes in control of their hands, arms, or legs along with the weakness such as incoordination or imbalance while walking. A neurological exam and clinical evaluation usually is needed and often a CT scan or MRI scan is performed to visualize the cervical spine and the nerve roots in order to determine the cause of the patient's symptoms. Many other diseases could cause similar symptoms. Your physician's examinations are necessary in order to determine the cause of the symptoms and to decide upon a treatment program. If symptoms progress especially with worsening pain or impaired function or neurological deficits, a neurosurgical consultation would be advised.
The MRI picture below is an image of a middle of the neck with the bottom or base of the head at the top of the picture. The longitudinal or sagittal view of the inside of this person's neck is as seen from the side and the base of the neck is seen at the bottom of the picture. When you view this midline section through the neck the spinal cord can be seen beginning from the brainstem at the base of the brain or head. The spinal cord descends through the water filled spinal canal (seen as white cerebral spinal fluid). In between the square blocks or vertebrae are the discs. The disc space is named by it's specific level in the neck. The C5-6 disc is between the fifth and sixth vertebrae. Due to the effects of aging and disc degeneration, spurs form or calcium deposits on the surface of the disc. The surface of the disc is made up of tough connective tissue fibers holding the vertebrae together. The ligamentum flavum in the back of the spinal canal is enlarged at the same level as the disc protrusion and spurs in the case. This ligament supports the neck but stretches and has elastic properties allowing for natural movements of the spine to occur. The MRI or side sagittal view seen below shows the largest spurs or OSTEOPHYTES projecting backwards causing compression of the spinal cord mainly at two levels, C3-4 and C5-6. Such deformity of the spinal cord and associated symptoms required a neurosurgical evaluation in order to determine after a complete examination methods of treatment including discussion of means to prevent future injury to the spinal cord.
Treatment may include an anterior cervical discectomy and fusion operation. Click here to visualize an x-ray of the completed procedure.http://drjerrymarlin.com/cervicalimage.html or these additionals images of an operation.
Update 6-21-99 JVM