Cervical spondylosis

Question 1

What is cervical spondylosis?

Answer 1

Age related degeneration of the cervical spine. Characterised by wearing away of cartilage and bones in neck. M:F = 1:1, other risk factors are mechanical stress, genetics and previous neck injuries

Question 2

What are the signs and symptoms of cervical spondylosis?

Answer 2

• Neck pain (may mimic headaches)
• Radiculopathy (compression of nerve roots) which can lead to flaccid upper limb paralysis - LMN
• Myelopathy (due to stretching of spinal cord) resulting in sensory changes and spastic paraparesis - UMN
• Bladder and bowel disturbence (rare)

Question 3

What is the differential diagnsosis of cervical spondylosis?

Answer 3

• Cervical disc herniation,
• Cervical stenosis,
• Rheumatoid arthritis
• Fibromyalgia

Question 4

What are the investigations for cervical spondylosis?

Answer 4

• History and examination
• X-ray
• MRI
• Electromyography to identify nerve root compression

Question 5

What is the management of cervical spondylosis?

Answer 5

• NSAIDs
• Surgical intervention for patient’s who do not respond to conservative treatment or those with severe/progressive neurological deficit. Options are anterior cervical decompression, posterior decompression or fusion techniques