cervical spondylosis is a very common disorder in the second half of life and results from degenerative, osteoarthritic change in the cervical spine
more than half of the population over 50 years are affected, of whom 20% have symptoms
onset is usually insidious. Relatively few require operative treatment
cervical spondylosis on an x-ray report refers to the radiographic changes associated with the degenerative process affecting the discs and the facet joints of the cervical spine
as in lumbar disc degeneration, the radiographic changes and symptoms suffered correlate poorly
most individuals will have some radiographic evidence of spondylosis from the age of about 35 years
it is well recognised that, though poorly understood why, previously asymptomatic individuals develop persistent spondylotic neck pain following a traumatic event, such as a whiplash injury, especially when radiographs confirm spondylotic changes which must have preceded the injury
as cervical degeneration progresses, the situation is complicated by hypertrophic facet joint changes, i.e. osteophytosis, and disc herniations - these facet joint changes may encroach upon nerve roots as they exit the spine in the exit foramina
may cause nerve root symptoms and potentially signs
cervical spine instability is relatively rare in purely degenerative spondylosis - however it is more common in inflammatory conditions which have the potential to affect the soft tissues of the neck, e.g. rheumatoid and psoriatic arthritis
in primary degenerative cervical disease, secondary neurological morbidity may arise and involve the nerve roots (radiculopathy), the spinal cord (myelopathy) or, less commonly, the vertebral arteries
compressive and/or ischaemic cervical myelopathy (due to local architectural and biomechanical disturbances resulting from the spondylotic process) is the commonest cause of spinal cord disturbance in the elderly
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