Spondylosis
Spondylosis is an umbrella term used to describe the degeneration of the spine. It can be used to describe pain and spine degeneration, regardless of what is the underlying cause of the pain and the location of the spinal degeneration.
Anatomy
The spinal column supports your body, allowing you to stand, bend, twist, lift, and complete everyday activities. It also helps protect your spinal cord from injury. There are 33 individual bones, called vertebra, stacked atop one another in the vertebral column.
The column is divided into different regions, the cervical, thoracic, lumbar, sacrum, and coccyx. The sacrum and coccyx are at the bottom of the column and are fused together. The 24 vertebrae located along the cervical, thoracic and lumbar sections are moveable.
Between each vertebra is an intervertebral disc. The discs keep your vertebrae from rubbing together. The discs have a strong exterior ring called an annulus, while the inside (nucleus) has a mucoprotein gel that acts like a shock absorber for your spine.
What is Spondylosis?
Spondylosis is a chronic degeneration of the spine that may involve the discs and vertebrae of the lumbar, cervical and thoracic spine, and is the most common cause of progressive spinal cord and nerve root compression. Spondylosis is a common condition that is estimated to account for 2% of all hospital admissions. It is the most common cause of spinal cord dysfunction in patients older than 55 years.
When this painful spinal condition occurs in the facet joint and breaks down the cartilage between them, it may be considered facet joint syndrome.
As people age, the intervertebral discs lose hydration and elasticity, which can cause fissures and cracks in the outer wall of the discs, and ultimately a flattening that causes the outer wall to bulge. This gradual deterioration of the discs between the vertebrae is also referred to as degenerative disc disease.
Cervical disc degeneration or cervical spondylosis involves the C1 to C7 vertebrae that make up the neck and upper part of the spine. As the cervical discs show signs of dehydration, they shrink. Symptoms of cervical osteoarthritis (neck arthritis) may develop. These symptoms may include:
- Neck pain and stiffness that is worse in the morning or at night
- Headaches that mostly occur in the back of the head
- Pain that radiates into shoulders and arms
- Muscle weakness that makes it hard to lift the arms or grasp objects firmly
Bone spurs, bony projections that develop along the edges of the vertebral joints, can also form with spondylosis.
Lumbar degenerative disc disease, or lumbar spondylosis, is diagnosed when the spinal discs of the lumbar vertebra degenerate. The lumbar vertebrae are number L1 to L5 and are in the lower back, which is why lumbar degenerative disc disease is linked to low back pain.
Spondylosis changes can also result in spinal stenosis and foraminal stenosis.
Causes of Spondylosis
Although age-related wear and tear of the vertebrae are the main cause of spondylosis, there are changes within the spinal anatomy that can lead to pain.
- Herniated discs. When cracks appear, the inner part of the disc can bulge out and become herniated. The herniated disc may then press on the spinal cord and nerve roots.
- Bone spurs. When bone spurs result from disc degeneration, they can pinch the spinal cord or nerve roots.
- Disc dehydration. By age 40, spinal discs begin to dry out and shrink, increasing the risk of bone-on-bone contact.
- Stiff ligaments. Ligaments connect bone to bone, so when the spinal ligaments become rigid with age, it can make the spine less flexible.
Additionally, injuries, such as those from a car accident or while playing sports, can enable disc degeneration.
Symptoms of Spondylosis
Spondylosis symptoms and especially cervical spondylosis may appear in those as young as 25. The condition generally begins earlier in men than in women. Many people with spondylosis that is seen on X-rays do not present any symptoms. In fact, lumbar spondylosis is present in 27%-37% of people without symptoms.
Common symptoms of spondylosis include:
- Sciatica
- Radiculopathy
- Radiculitis
- Pinched nerves
- Localized pain and regional tenderness
- Muscle spasms
- Pain that worsens with prolonged standing, sitting and forward bending
- Numbness and tingling
- Weakness in one or more limbs
- Loss of bladder or bowel control
Diagnosing Spondylosis
As many people with spondylosis do not present symptoms, specific testing may be needed to get a medical diagnosis. If positive, a physician may use more specific terminology regarding your condition such as cervical degenerative disc disease, cervical spinal stenosis, or lumbar spinal stenosis as they describe the pain more effectively.
A doctor will begin with a physical examination to check your range of motion, reflexes, muscle strength and walk to observe if there are changes in your gait.
Imaging studies, such as an x-ray, MRI, or CT scans can provide detailed views of your spine. Electromyography (EMG) may also be performed to measure the electrical activity from your nerves to muscles.
Risk Factors
Approximately 90% of men ages 50 and older — and 90% of women ages 60 and older — have evidence of degenerative changes in the spine.
Some of the risk factors for this condition include:
- Repeated strains and sprains
- Occupation – such as jobs that require repetitive motions involving the neck or back
- Previous neck injuries
- Genetics
- Smoking
Treatment for Spondylosis
The severity of your symptoms and diagnostic imaging results will determine the spondylosis treatment plan that is best for you. Often, conservative treatments will be suggested to relieve pain and help you get back to everyday life.
In severe cases or when non-surgical treatments for spondylosis fail to provide relief, surgical treatment may be recommended.
Non-Surgical Treatment
In mild to moderate cases of spondylosis, non-surgical treatment options can be effective. These options include:
- Lifestyle changes
- Rest
- Over-the-counter anti-inflammatory drugs
- Physical therapy
- Cortisone shots
- Chiropractic adjustments
- Prescription pain medication
Surgical Treatment
Whether you have cervical (neck), lumbar (lower back), or thoracic (mid-back) spondylosis, the patented Bonati Spine Procedures are unrivaled in their safety and effectiveness.
The procedures are performed through a small incision in the back while the patient is conscious under local anesthetic and IV sedation. Since the patient is awake during spinal surgery, anesthesia risk is minimal and post-operative recovery time is greatly reduced.
When surgery is required for spondylosis, The Bonati Spine Procedures offer an array of surgical techniques that may include:
Nerve Decompression
Posterior approach — the procedure is performed on the patient to remove bone spurs, enlarged ligaments, or scar tissue that are compressing the spinal cord and/or nerves leading to the extremities. This procedure is usually employed to treat degenerative disc disease and/or facet joint arthritis. It may also be used for treating patients that had previous surgeries including spinal fusions.
Foraminectomy/Foraminotomy
This is a procedure in which the foramen of the vertebrae — the canal through which a nerve root exits the spine — is returned to its normal width after it has been narrowed due to degenerative disc disease or spinal arthritis. Bone spurs, scar tissue or bulging and herniated discs that form as a result of degenerative disc disease or spinal arthritis may narrow the foraminal canal, causing different spinal disorders. Foraminectomy/foraminotomy widens the foraminal canal to its normal width.
Facet Thermal Ablation
A Facet Thermal Ablation is a laser eradication of sensory nerves causing pain. During a Bonati Facet Thermal Ablation (Rhizolysis), surgeons vaporize irritated and painful nerves around the facets of the vertebrae.
Prevention & Self-Care
You may have a higher risk of developing spondylosis due to a family history, your job or other risk factors. However, simple changes in your lifestyle can improve your spine health and potentially reduce the pain or severity of this condition.
- Develop a regular exercise routine
- Maintain a healthy weight
- Eat nutritious and healthy food
- Stretch through the day
- Develop good posture
- Learn how to lift properly
- Stop smoking
- Avoid alcohol
- Hydrate
Outlook
The Bonati Spine Procedures can successfully treat patients suffering from spondylitis. Spondylosis is a result of the natural aging process and due to its degenerative nature, this condition may be treated but not stopped. Many patients will become asymptomatic with proper treatment while others may use various methods and need further treatment as they age to manage the symptoms of spondylosis.