Spine: Spondylosis

Question 1

Define spondylosis

Answer 1

Osteoarthritis of the spine including degeneration of the disc or facet joints

Question 2

What are the causes/risk factors of spondylosis?

Answer 2

Spontaneous joint degeneration related to age and wear & tear
Thinning of discs (loss of water in nucleus pulposus) ->
narrowing of joint and bulging of disc -> increased pressure and weight bearing on facet joints -> osteophyte formation
- Radiculopathy – impingement of nerve roots
- Myelopathy – narrowing of spinal canal and
compression of spinal cord

Risk factors
• Increasing age
• Family history (genetic predisposition)
• History of trauma or cervical surgery

Question 3

What are the symptoms of spondylosis?

Answer 3

• Asymptomatic
• Decreased cervical range of motion
• Neck pain
• Cervical muscle pain and spasm
• Headaches

Radiculopathy
• Proximal arm weakness
• Numbness
• Pain radiating down arm

Myelopathy
• Distal hand weakness

Question 4

What are the signs of spondylosis?

Answer 4

Radiculopathy
• Hyporeflexia

Myelopathy
• Hyperreflexia
• Gait ataxia

Question 5

What investigations are carried out for spondylosis?

Answer 5

• Cervical X-Ray - presence of degenerative joint or disc disease, fracture or instability
• Cervical MRI - bone destruction and spinal cord or nerve compression.
• Cervical CT - with contrast; bone destruction and spinal cord or nerve compression.
• EMG - may show changes of muscle denervation; localises the problem to the root or reveals changes in keeping with peripheral nerve entrapment