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25+ years of experience

Cervical Spondylitis

Dr P K Jha


Senior Neurosurgeon and Director
MBBS, MS, MNAMS, M.Ch (AIIMS, N.Delhi)

Senior Neurosurgeon Dr. P K Jha, with more than 25 years of experience in spine surgery, sheds light on cervical spondylitis. He discusses its prevalence, causes, pathogenesis, symptoms, signs, investigations, radiology, treatment options, surgery (both open and endoscopic), prevention, and rehabilitation. This comprehensive guide aims to help the general public understand cervical spondylitis better and take timely action to prevent severe complications.


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Cervical Spondylitis: Understanding, Prevention, and Treatment

Introduction to Cervical Spondylitis

Cervical spondylitis, also known as cervical osteoarthritis, is a common age-related condition affecting the joints and discs in the cervical spine. It involves the degeneration of the vertebrae, discs, and ligaments in the neck. As a leading expert in spine surgery, Dr. P K Jha explains the condition in detail to raise awareness and promote early intervention.


Prevalence

Cervical spondylitis is prevalent worldwide, particularly among individuals over the age of 50. It is estimated that over 85% of people aged 60 and older are affected by cervical spondylitis to some extent. The condition is also becoming more common in younger adults due to sedentary lifestyles and prolonged use of computers and mobile devices.


Causes

The primary cause of cervical spondylitis is the wear and tear of the cartilage and bones in the cervical spine over time. Factors contributing to this degeneration include aging, repetitive stress, poor posture, injuries, and genetic predisposition. Other risk factors include smoking, obesity, and sedentary lifestyle.


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Pathogenesis

The pathogenesis of cervical spondylitis involves the gradual degeneration of the intervertebral discs, which leads to the formation of bone spurs (osteophytes) and the narrowing of the spinal canal. This degeneration can cause compression of the spinal cord and nerve roots, resulting in pain and neurological symptoms. Increasing physical as well as mental stress leads to loss of water from the disc, its desiccation or drying, reduction of vertebral height (gap), friction of adjacent vertebrae, formation of bony spurs, compromise of nerve root canal, its compression, and symptoms of pain and tingling in the related nerve area on the skin or muscle. There is also a loss of cervical lordosis (normal forward convexity), which nullifies the load of the weight of the head on the spine (failed mechanics of weight bearing). Further movement of the head and forward bending, coupled with continued stress due to pain, leads to spasticity, creating a vicious cycle.

Those who resist accepting and adapting to life situations and people, tend to lose the flexibility of their spine. It's the body's way of saying, "I am suffering, and you continue to stress my spine by putting resistance. But now, stop that. I can recover."
Acceptance, allowing, loving, and letting things unfold naturally while keeping yourself unhurt is the way to go. Embracing this mindset can restore spinal flexibility and ease the body's distress, creating a harmonious balance between mind and body.


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Symptoms

Symptoms of cervical spondylitis can vary widely but commonly include neck pain and stiffness, headaches, pain in the shoulders and arms, and tingling or numbness in the arms and hands. In severe cases, it can cause loss of balance, coordination issues, and bladder or bowel dysfunction.


Signs

Physical examination signs may include reduced range of motion in the neck, muscle weakness, and abnormal reflexes. Palpation of the neck may reveal tenderness and muscle spasms. Neurological examination is crucial to assess the extent of nerve involvement.


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Investigations

Investigations to diagnose cervical spondylitis include X-rays to identify bone spurs and disc degeneration, MRI scans to visualize soft tissues and spinal cord compression, and CT scans for detailed images of the bone structure. Electromyography (EMG) and nerve conduction studies may be used to assess nerve function.

Radiology

Radiological imaging is essential for diagnosing and evaluating the severity of cervical spondylitis. X-rays can show bone changes and alignment issues, while MRI provides detailed images of the spinal cord, nerves, and discs, highlighting any compression or herniation.


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Treatment Options for Cervical Spondylitis

Treatment for cervical spondylitis ranges from conservative management to surgical intervention. Initial treatment often includes physical therapy, medications such as NSAIDs and muscle relaxants, and lifestyle modifications. Severe cases may require corticosteroid injections or surgical options.


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Surgical Treatment for Cervical Spondylitis

Surgery is considered when conservative treatments fail, and there is significant nerve compression or spinal cord involvement. Surgical options include:

  • Open Surgery: Traditional approach involving a larger incision to access the spine and remove bone spurs, herniated discs, or perform spinal fusion.
  • Endoscopic Surgery: Minimally invasive technique using small incisions and an endoscope to remove herniated discs or decompress nerves, resulting in quicker recovery.

Prevention

Preventive measures include maintaining good posture, regular exercise to strengthen neck and back muscles, avoiding repetitive neck strain, and leading a healthy lifestyle to reduce risk factors such as obesity and smoking. Dr. P K Jha emphasizes the importance of early diagnosis, personalized treatment plans, and ongoing patient education for optimal outcomes.


Rehabilitation for Cervical Spondylitis

Rehabilitation plays a crucial role in recovery. It involves physical therapy to improve strength and flexibility, ergonomic adjustments at work and home, and education on maintaining proper posture and body mechanics to prevent recurrence.


Complications of Cervical Spondylitis

Complications can include chronic pain, significant disability, and in severe cases, spinal cord damage leading to paralysis or other neurological deficits. Timely intervention is critical to prevent such outcomes.


Prognosis for Cervical Spondylitis

With appropriate treatment and lifestyle modifications, many patients experience significant symptom relief and improved quality of life. However, the prognosis varies based on the severity of the condition and the effectiveness of the treatment plan.


Review of the Article

  • Introduction to Cervical Spondylitis - Age-related condition affecting the cervical spine.
  • Prevalence of Cervical Spondylitis - Common in individuals over 50, increasingly seen in younger adults.
  • Causes of Cervical Spondylitis - Aging, repetitive stress, poor posture, injuries, genetics.
  • Pathogenesis of Cervical Spondylitis - Degeneration leading to spinal cord and nerve compression.
  • Symptoms of Cervical Spondylitis - Neck pain, stiffness, headaches, neurological symptoms.
  • Signs of Cervical Spondylitis - Reduced neck motion, muscle weakness, abnormal reflexes.
  • Investigations for Cervical Spondylitis - X-rays, MRI, CT scans, EMG.
  • Radiology in Cervical Spondylitis - Essential for diagnosing and evaluating severity.
  • Treatment Options for Cervical Spondylitis - Physical therapy, medications, lifestyle changes.
  • Surgical Treatment for Cervical Spondylitis - Open and endoscopic surgeries for severe cases.
  • Prevention of Cervical Spondylitis - Good posture, exercise, avoiding neck strain.
  • Rehabilitation for Cervical Spondylitis - Physical therapy, ergonomic adjustments, education.
  • Role of Doctors in Managing Cervical Spondylitis - Multidisciplinary approach for optimal outcomes.
  • Complications of Cervical Spondylitis - Chronic pain, disability, potential spinal cord damage.
  • Prognosis for Cervical Spondylitis - Varies based on severity and treatment effectiveness.

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