Cervical Osteoarthritis (Cervical Spondylosis)
What Are the Treatments for Cervical Spondylosis?
In most cases, cervical spondylosis treatments are conservative. They include:
- Use of nonsteroidal anti-inflammatory drugs (NSAIDs) or other non-narcotic products to relieve pain from inflammation
- Chiropractic manipulation that can help to control episodes of more severe pain
- Wearing a cervical collar to limit movement and provide support
- Other forms of physical therapy, including the application of heat and cold therapy, traction, or exercise
- Injecting drugs (corticosteroids and a local anesthetic) into the joints of the spine or the area surrounding the spine, known as epidural steroid injection or cervical facet joint injection
When Is Surgery Needed for Cervical Spondylosis?
Cervical spondylosis tends to be a chronic (long-term) condition. But in most cases, it is not progressive. Surgery is required only in rare cases. The goal of surgery is to remove the source of pressure on the spinal cord and nerves. The surgery may also include adding stabilization in the form of implants or through fusion of the vertebrae. But surgery is considered only when there is a severe loss of function. For instance, it might be considered if you had a progressive loss of feeling and function in your arms, legs, feet, or fingers. Any type of spinal cord compression could result in permanent functional disability.
The surgeon can approach the cervical spine from the front (anterior) or the back (posterior). Approaching from the front might be used to remove the discs and spurs that are causing pressure. The disc may be replaced with an implant. A more extensive surgery calls for the removal of both discs and parts of the vertebra. These parts are replaced with a bone graft or implant.
Approaching from the back would be used to perform either a laminectomy or a laminoplasty. In a laminectomy, the rear parts of the vertebrae in the neck -- the lamina and spinous processes -- are removed. In a laminoplasty, the vertebra is left in place, but is cut free along one side. Both procedures relieve pressure on the spinal cord or nerves.
As with any surgery, there is risk of infection or complications with anesthesia. Surgery is usually followed by a rehabilitation program.