Spondylosis

Spondylosis is an umbrella term for different forms of age-­related degeneration of the spine.

The bones of the spine are called the vertebrae. Between each pair of vertebrae, there are three joints. There is a joint in the front of the spine that is called an intervertebral disc. There are two joints in the back of the spine, which are called facet joints. These joints are made of cartilage and cushion the bones. Ligaments are around the spinal column and connect the vertebrae together. These help to support the joints and bones.

As people age, their bones, discs, cartilage, and ligaments change. Bone spurs (abnormal overgrowth of bones) may develop, discs may dry and crack, cartilage may wear out, and ligaments may thicken. These age-related degenerative changes are all forms of spondylosis.

Symptoms

Spondylosis does not always cause symptoms. When symptoms do occur, they typically include neck or back pain or stiffness.

Spondylosis can lead to spinal stenosis, which is a narrowing of the spinal canal. As a result, the spinal cord and/or spinal nerve roots can become compressed (pinched). For example, the cervical spinal cord can be affected by compression from spondylosis. This is called cervical spondylotic myelopathy. Symptoms of cervical spondylotic myelopathy include:

  • Tingling and numbness in the arms, hands, legs, and/or feet
  • Weakness in the muscles of the arms, shoulders, legs, feet, and/or hands
  • Coordination problems

Diagnosis

If a patient presents with symptoms associated with spondylosis, the doctor may order an X-ray to help identify any changes in the bones of the spine.

The doctor may also order the following diagnostic procedures:

  • Magnetic resonance (MR) scan: provides a detailed image of the spinal cord and surrounding nerves. This diagnostic procedure can help identify if a nerve is being compressed.
  • Computed tomography (CT) scan: provides more detailed images of the bones

If there is a concern that spondylosis has begun to compress nerve tissue in the spine, the doctor may order a test to evaluate whether the nerve signals are traveling properly to the muscles.

Risk Factors

Spondylosis is caused by wear and tear on the components of the spine. The major risk factor for developing spondylosis is age. In fact, by age 60 most people will show signs of spondylosis on X-ray.

Treatments

Typically, non-operative measures are effective in treating the symptoms associated with spondylosis. Non-operative measures include pain medications and physical therapy.

However, if spondylosis has resulted in compression of the spinal cord or spinal nerve roots, surgery may be necessary to relieve the pressure.

The type of surgery required varies depending on the cause of the spinal cord compression. The neurosurgeons at the Spine Hospital at the Neurological Institute of New York are skilled at determining the best treatment for each patient and each situation.

Options include:

  • Discectomy: to remove a herniated disk
  • Laminectomy: to remove bone spurs or remove part of the vertebra called the lamina
  • Laminoplasty: to open the space for nerve tissue by changing the position of the lamina
  • Spinal fusion: fusing a segment of the spine using a transplanted bone with or without instruments (ex: rods and screws)