• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Home
  • TeleConsult
  • About
  • Newsletter/Updates
  • Contact Us
  • Policies

Bone and Spine

Orthopedic health, conditions and treatment

  • General Ortho
  • Procedures
  • Spine
  • Upper Limb
  • Lower Limb
  • Pain
  • Trauma
  • Tumors

Spondylosis – Definition, Causes and Treatment

By Dr Arun Pal Singh

In this article
    • Types of Spondylosis
    • Terms Sounding similar to Spondylosis but with Different Meaning
    • Risk Factors for Spondylosis
      • Clinical Presentation
    • Diagnostic Work Up
    • Treatment of Spondylosis
      • Conservative Treatment
      • Surgical Treatment
      • Related

Spondylosis as a medical term denotes degenerative changes that occur in the spine as a natural aging process for some other reason. The term degeneration means the wear and tear that accumulates.

The bone spurs and degeneration of intervertebral discs are examples of degeneration.

The term is from the Ancient Greek word ‘spondylos’ which [plural of spondylus or vertebra] mean vertebrae or spine.

In some cases, physicians also use the term more specifically to describe the presence of spinal osteoarthritis or degenerative disc disease.

The degenerative process in osteoarthritis chiefly affects the vertebral bodies, the neural foramina, and the facet joints.

The spondylosis may be present in a person without causing any symptoms, especially in the early stages. The progression of spondylosis may cause symptoms in some persons and the symptoms in these cases depend on the site and severity.

It can cause pain in the neck in the cervical region and pain in back in lower spine regions. Compression of spinal cord or nerve roots can lead to sensory and motor disturbances including radicular pain, paresthesia, and muscle weakness in the limbs.

Types of Spondylosis

Depending on the part of the spine involved, the spondylosis can be

  • Cervical
  • Thoracic
  • Lumbar [or lumbosacral]
  • Multiple levels

Terms Sounding similar to Spondylosis but with Different Meaning

Spondylitis is inflammation of one or more vertebrae. For example ankylosing spondylitis. [In contrast to the inflammatory nature of spondylitis, spondylosis is degenerative].

Spondylolysis is a defect in the pars interarticularis which connects upper and lower facets. This defect predisposes to spondylolisthesis.

spondylolysis and spondylolisthesis
Spondylolysis and spondylolisthesis. Image credit: Open i

Spondylolisthesis is the displacement of the body of one vertebra in relation to an adjacent vertebra. For example, an anterior slip of L5 on S1 as shown in the image above. But the displaced vertebra would not slip alone, the spine above it slips along too, creating a misalignment of the spine at the level of the slip.

Spondylosis deformans is a probably inflammatory condition where discs degenerate and bony spurs or bridges occur around the disc and nearby joints of the spine.

Risk Factors for Spondylosis

The condition results from the added effect of effects of ongoing wear and tear. But a number of risk factors can increase the likelihood. These risk factors include

  • Obesity
  • Genetic predisposition
  • Trauma
  • Participating in high-impact sports

Anything that leads to increased wear and tear of the spine tissues – discs, tendons, muscles, ligaments, and cartilage.

Here are some of the most common types of spondylosis affecting people

  • Degenerative disc disease
    • Degeneration of  one or more of the intervertebral discs t
    • Discs weaken, bulge or rupture
    • Compression of nearby nerve roots and even the spinal cord.
  • Facet Arthritis
    • Arthritis of one or more of the facet joints t
    • Wearing of cartilage leads to painful joint movements
    • Formation of osteophytes or bone spurs
  • Spinal stenosis
    • Gradual narrowing of the spinal canal,
    • Causes the constriction of the spinal cord or nerve roots
    • Usually caused by cumulative effects of other spondylosis like osteophytes or herniated disc.

Clinical Presentation

One may have spondylosis and still have no symptoms as the symptoms do not appear unless the condition has progressed enough or result in some nerve root compression.

Following are the general symptoms, a patient of spondylosis may experience. Not all the symptoms are present in all the patients.

  • Pain in the affected area [neck or back] – Pain could be acute or chronic
  • Loss of sensation [the site would depend upon the vertebral level where neural tissue is compressed.
  • Radiating pain
    • In arm and around shoulders [cervical]
    • Chest and abdomen [thoracic]
    • Pelvic area and lower limbs [lumbar]
  • Stiff back
  • Muscle cramps esp in lower limb in case of lumbar disease

Diagnostic Work Up

A good history with the physical examination is the first line of evaluation followed by imaging is the usual line of approach for diagnosis.

X-ray is the basic investigation. It very well shows the degenerative changes like osteophytes, reduction in joint space and any change in curvature of the spine.

X-rays are also helpful to rule out any other pathology that might be causing the symptoms.

X-rays do not show soft tissues well. Therefore, the disc and ligaments are not visible on x-rays.

MRI is the investigation of choice in case of suspected disc herniations and spinal stenosis. It is able to show the status of neural tissue and any compression caused.

Most of the cases of spondylosis are diagnosed on the clinical basis only. X-rays may be needed in selected patients or patients who do not improve with treatment.

MRI is required in few cases of back pain especially when there is an involvement of neural tissue.

Treatment of Spondylosis

Most of the cases of spondylosis are managed conservatively. Surgery is required in a small percentage of people either having acute unrelenting symptoms or patients who do not improve on conservative treatment.

Generally, surgical is recommended only after a patient attempts several weeks or months of conservative treatment, but continues to experience symptoms.

Conservative Treatment

Pain Relief Drugs

Oral NSAIDs and opioid drugs are often the first line drugs. Muscle relaxants can be given to relieve the spasm but sedation is a side effect.

Some patients are benefited by antidepressants like amitriptyline and drugs given for neuropathic pains like pregabalin.

Drugs lessen the pain and anti-inflammatory drugs also reduce the inflammation and swelling.

Physical therapy

This is an essential part of spondylosis treatment. The aim is to strengthen core muscles like muscles of the abdomen and pelvis and the spinal musculatures. As muscles strengthen, they take some of the pressure off of your vertebrae and joints. Improving cardiovascular health, increasing flexibility and muscle endurance are other goals of exercise therapy.

The exercises are performed under supervision.

Lifestyle changes

Weight is an important risk factor for progression and people would benefit from weight loss. Weight loss reduces the loads on spine leading to betterment.

Similarly quitting smoking helps to get better blood circulation of the spine and healing potential gets better.

Patient needs to adopt good postures for daily jobs including sitting and sleeping.

At the job station, the ergonomic arrangement of the stuff goes a long way.

Prolonged sitting is to be avoided.

CAM

Though the role of complimentary and alternative medicine is to be established, acupressure, acupuncture and yoga have been claimed to be beneficial.

Steroid Injections

Steroid injections provide longer relief than oral medications and can be considered in patients who are not responding.

Facet joint injections and epidural steroid injections are the two most common types of injections given.

Surgical Treatment

Surgery is occasionally indicated.

In cervical spondylosis, surgery is advocated for in patients

  • With  intractable pain
  • Progressive symptoms
  • Weakness that fails to improve with conservative therapy.
  • Myelopathy.

In lumbar spondylosis, the surgery is indicated if there is a compromise of the canal space with symptoms not improving on conservative treatment.

The basic purpose of the surgery is to decompress the neural tissue and/or fuse the painful joints.

There are many procedural options for surgical decompression.

  • Foraminotomy
    • Considered when foraminal stenosis is present
    • Relieves pressure on a nerve root exiting a foraminal canal
  • Laminotomy
    • Relieves pressure on the spinal cord by decompressing it
  • Discectomy
    • Removes a part of a bulging or herniated disc causing compression
  • Fusion surgery
    • To stop of motion of painful joint
    • Can be fixed with an implant
    • Bone grafting is done for fusion

Related

Spread the Knowledge
12
Shares
 
12
Shares
 12   

Filed Under: Spine

About Dr Arun Pal Singh

Arun Pal Singh is an orthopedic and trauma surgeon, founder and chief editor of this website. He works in Kanwar Bone and Spine Clinic, Dasuya, Hoshiarpur, Punjab.

This website is an effort to educate and support people and medical personnel on orthopedic issues and musculoskeletal health.

You can follow him on Facebook, Linkedin and Twitter

Primary Sidebar

Browse Articles

Swimmer's View - Both Arms Up Xray

What is Swimmer’s View Xray?

The swimmer’s view is an x-ray of the cervicothoracic junction that helps demonstrate the upper thoracic and the seventh cervical vertebrae. The swimmer’s view is an important view for evaluating the relationship of the cervicothoracic junction and upper thoracic vertebrae C7 through T3. Swimmer’s view x-ray is a difficult x-ray. Its positioning is difficult and […]

Types of Meniscal tear

Meniscal Tear Causes, Presentation and Treatment

Meniscal injuries or meniscal tear are common sports-related injury among adults. These are less common in skeletally immature persons and very rare in children younger than 10 years. The injuries are more common in males than females. The second peak of incidence is observed in elderly persons older than 55 years secondary to the degenerate […]

thenar flap for finger tip injuries

Fingertip Injuries of The Hand

Fingertip injuries can be crushing, tearing, or amputating injuries to the tips of fingers and thumbs. Injury can include damage to skin and soft tissue, bone (distal phalanx), or to the nail and nailbed. The tips of longer fingers tend to be injured more . Classification of Fingertip Injuries of The Hand Mostly used classification […]

Rolando Fracture

Base of Thumb Fractures and Their Types

Base of thumb fractures are the extra-articular and intraarticular fractures of base of first metacarpal bone. Thumb is a highly important and efficient digit that makes the human hand highly efficient. An unusable thumb could mean a loss of 40% of hand function. Relevant Anatomy [Read complete hand anatomy] Thumb consists of two phalanges and […]

Broken implant in spine injury, for TLICS

TLICS- Thoracolumbar Injury Classification and Severity Score

Thoracolumbar injury classification and severity score or TLICSĀ  is a scoring system for thoracolumbar fractures which classifies and provides guidance to the treatment as well. TLICS is based on three major categories Morphology of the injury Integrity of the posterior ligamentous complex Neurologic status of the patient. Denis classification of spinal injuries which is based […]

Lateral view of ankle joint

Ankle Joint Anatomy

The ankle joint is a hinged synovial joint. In an absolute sense, its primary movements are moving the foot up and down, called dorsiflexion and plantar flexion respectively. However, this joint works in tandem with subtalar joints [talocalcaneal and talocalcaneonavicular], thus adding to the range of motion of this ankle-subtalar joint complex. Anatomically subtalar (talocalcaneal) […]

C2 vertebra from above

Axis or Second Cervical Vertebra [C2]

Axis is the second vertebra of the spine and is also called C2 bone vertebra. It articulates with C1 or atlas vertebra above and C3 vertebra below. The axis is an atypical cervical vertebra like atlas and vertebra prominens or C7 vertebra. It forms a pivot for atlas to rotate providing greater range of motion […]

© Copyright: BoneAndSpine.com
Manage Cookie Consent
The site uses cookies. Please accept cookies for a better visiting experience.
Functional Always active
The technical storage or access is strictly necessary for the legitimate purpose of enabling the use of a specific service explicitly requested by the subscriber or user, or for the sole purpose of carrying out the transmission of a communication over an electronic communications network.
Preferences
The technical storage or access is necessary for the legitimate purpose of storing preferences that are not requested by the subscriber or user.
Statistics
The technical storage or access that is used exclusively for statistical purposes. The technical storage or access that is used exclusively for anonymous statistical purposes. Without a subpoena, voluntary compliance on the part of your Internet Service Provider, or additional records from a third party, information stored or retrieved for this purpose alone cannot usually be used to identify you.
Marketing
The technical storage or access is required to create user profiles to send advertising, or to track the user on a website or across several websites for similar marketing purposes.
Manage options Manage services Manage vendors Read more about these purposes
View preferences
{title} {title} {title}
 

Loading Comments...