Cervical Osteoarthritis (Cervical Spondylosis)
How Is Cervical Spondylosis Diagnosed?
The doctor will generally begin by asking you about symptoms and taking a medical history. This will be followed by a physical exam of the body, with a focus on the neck, back, and shoulders. The doctor is also likely to test reflexes and the strength of hands and arms, check for loss of sensation, and watch you walk.
Other tests that might be done include imaging exams such as X-rays, computed tomography (CT), and magnetic resonance imaging (MRI). MRI scans use large magnets, radio waves, and a computer to produce the best images of the body. You might also be referred to a neurologist.
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.