Date Published: November 28, 2012
Publisher: Hindawi Publishing Corporation
Author(s): John C. Kelly, Patrick J. Groarke, Joseph S. Butler, Ashley R. Poynton, John M. O’Byrne.
Cervical spondylosis is a broad term which describes the age related chronic disc degeneration, which can also affect the cervical vertebrae, the facet and other joints and their associated soft tissue supports. Evidence of spondylitic change is frequently found in many asymptomatic adults. Radiculopathy is a result of intervertebral foramina narrowing. Narrowing of the spinal canal can result in spinal cord compression, ultimately resulting in cervical spondylosis myelopathy. This review article examines the current literature in relation to the cervical spondylosis and describes the three clinical syndromes of axial neck pain, cervical radiculopathy and cervical myelopathy
Cervical spondylosis is a broad term which describes the age-related chronic disc degeneration, which can also affect the cervical vertebrae, the facet, and other joints and their associated soft tissue supports. Chronic disc degeneration results in increased mechanical stressors passing through the cervical spinal column, resulting in osteophyte formation and secondary degenerative changes in surrounding structures, such as the facet joints, the posterior longitudinal ligament (PLL), and the ligamentum flavum. These degenerative changes and their associated nerve impingement are then responsible for the three clinical syndromes in which cervical spondylosis presents. Cervical spondylosis is generally classified according to these three clinical syndromes or means of presentation: axial neck pain, cervical radiculopathy, and cervical myelopathy. Patients can have a combination of any of the three syndromes. Evidence of spondylotic change is frequently found in many asymptomatic adults , with 25% of adults under the age of 40, 50% of adults over the age of 40, and 85% of adults over the age of 60 showing some evidence of disc degeneration [2, 3]. Another study of asymptomatic adults showed significant degenerative changes at 1 or more levels in 70% of women and 95% of men at age 65 and 60 . The most common evidence of degeneration is found at C5-6 followed by C6-7 and C4-5 . Treatment for mild and moderate disease is typically conservative with surgical intervention advised for those with severe intractable pain, progressive disease, and for those with associated weakness and neurological deficits.
Cervical spondylosis can present itself in a multitude of ways. It can often be asymptomatic, it can can cause neck pain, regional pain, and can cause neurologic deficits of the sphincters, torso, or the extremities if there is spinal cord involvement .