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Spondylosis, Cervical

The cervical region of the spine comprises the seven uppermost vertebrae in the spinal column and their supporting structures.

What is it?

Cervical spondylosis is a general term for degeneration of the structures in the cervical (neck) region of the spine. The seven cervical vertebrae constitute the top portion of the spine—the long, flexible column of bones that supports the skeleton and protects the spinal cord. Flat, circular pads of cartilage known as intervertebral disks serve as cushions between the vertebrae and allow for smooth movement. In spondylosis, rupture of a disk, or overgrowth of the vertebrae or the ligaments that support the spine, or a combination of these may compress the spinal cord or the nerves entering or exiting the spinal cord, causing pain and other symptoms (see Spinal Stenosis or Intervertebral Disk, Herniated, for more information). Spondylosis is common among those of middle age and older; many cases are mild and respond well to self-treatment.

What Causes It?

  • Aging causes changes in the spinal column that result in spinal stenosis—to the extent that everyone with spinal stenosis shows evidence of the disorder on an x-ray. However, symptoms vary and some patients don't experience any pain.
  • Prior neck injuries may increase the risk.

Prevention

  • There is no way to prevent cervical spondylosis.

Diagnosis

  • Patient history and physical examination are needed.
  • Spinal x-ray, CT (computed tomography) scan, or MRI (magnetic resonance imaging) usually confirms the diagnosis.
  • Myelography (injection of a contrast material into the space around the spinal cord to highlight spinal abnormalities during x-rays) is sometimes performed.

How to Treat It

  • Mild cases of cervical spondylosis may resolve on their own. Rest and immobilization of the neck with a brace may aid in recovery.
  • Over-the-counter analgesics may be used for minor pain. For more severe cases prescription painkillers, muscle relaxants, or tranquilizers may be warranted.
  • Traction therapy may be required if pain persists. This is usually done on an outpatient basis and, if effective, can be continued at home.
  • In advanced cases surgery may be performed to relieve pressure on the spinal nerves. Surgery may involve removing bony overgrowth in the vertebrae, fusing affected vertebrae together to prevent harmful joint movement, or both.
  • Exercise or physical therapy may be recommended.

When to Call a Doctor

  • Call a doctor if persistent neck pain does not respond to self-treatment.