Cervical spondylosis

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Cervical spondylosis is a degenerative condition caused by wear & tear of the joints leading to pain and stiffness in the neck. Generally it begins around the age of 25 years. It is more common in people who have to bend the neck during their work eg. Writters, clerks, housewives or whose vertebral column sustains more jerks eg. Driver, atheletes etc., Wrong posture is also a common cause.


This degenerative condition is characterised by 

1) Degeneration of the formation of bony ridges running across the anterior surface of the neural canal.

2) he formation of osteophytes from the neuro central joints of Luschka which project backwards into the intervertebral foramen. The condition may be quite symptomless or may cause neurological symptoms.


Clinical features


Pain and stiffness in the neck are common symptoms. The pain is often radiated to either or some times to both the upper limbs. Osteophytes may press the nerve roots so the movement of the neck may damage the nerves there by producing sensation of numbness and tingling or may make muscles become weak. Giddiness is an occasional symptom so in all cases of giddiness diagnosis of cervical spondylosis should be ruled out. Rarely in severe cases, The osteophytes project backwards behind the disc and may lead to weakness and loss of sensations in the lower part of the body.


Differential diagnosis


If the seventh cervical and first thoracic roots are affected by spondylosis the pain may resemble that of coronary artery disease. Myelopathy due to cervical spondylosis may resemble tumour of the spinal cord, syringomyelia, disseminated sclerosis, motor neurone disease or sub acute combined degeneration of spinal cord. The acute disc herniation syndrome must be differentiated from other causes of brachial neuralgia.


Diagnosis


Radiological examination shows narrowing of the disc spaces and osteophyte formation with loss of normal cervical lordosis. Lesion at the level of C4-C5 vertebrae is very common. Pain in cervical region being refferred to the hand is very much diagnostic of cervical spondylosis.

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