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Spondylosis

SPONDYLOSIS – Causes, Symptoms & Treatment

Also known as osteoarthritis, it is associated with the wear and tear of the bones, ligaments, and weakening of the spinal discs. Spondylosis usually affects the elderly but the symptoms can be seen as early as in 20 years of age. Globally, over 80% people above the age of 50 are affected by this. Spondylosis is different from spondylitis; while spondylitis is associated with inflammation, spondylosis implies pain and degeneration of bones.

Causes

The possible causes for Spondylosis condition could be:

  • Bone spurs or overgrowth that the body initiates to support the spine. This extra growth does not find space and tends to press the delicate areas like the spinal cord, nerves or the discs.
  • Dry spinal discs are one major cause. The soft cushioning discs between the vertebrae absorb jerks and shocks and provide padding against friction due to movement. The disc holds a gel-like substance which tends to dry out due to age or any internal disorder. The vertebrae are devoid of padding and rub against each other while moving. This causes friction and pain.
  • Herniated discs develop when the cushioning disc cracks or juts out and the gel within leaks. Now, this protruding disc can press the cord or nerves which cause Nerve Pains.
  • Any past injury or accident trauma which might have affected the neck or lower back can render the bones related structure weak and lead to spondylosis in later age.
  • Connecting ligaments between bones tend to stiffen over time and restrict movement, especially in the neck region. These, when moved with force, can cause pain.
  • Occupations that involve lifting a heavy weight or a continuous repetitive movement of the back/ neck cause wearing out of the bones that have been exerted the most. Heavy weight lifting in the gym (non-supervised) over the time can cause spinal wear and tear.

 

Symptoms

  • This can occur in the cervical spine (neck region), middle back or the lumbar spine (lower back). Common signs are stiffness in the neck, difficulty in movements, headaches, neck and shoulder pains.
  • Localized pain in the area of damage, mostly along the shoulder blade.
  • If the spondylosis has resulted in a herniated disc the person might experience sharp shooting pain that increases with movement. The other symptoms then are similar to that of slip disc.
  • If there is an injury to the spinal cord it is referred to as myelopathy and the symptoms include pain, numbness, weakness, and tingling.
  • If spondylosis results in nerve pinching, the symptoms are felt along the course of the nerve and include pain, tingling, and weakness.
  • Spondylosis in the lumbar spine can cause pain that shoots down the thighs to behind the knees and sometimes can go lower to the calf muscles. This is called radiculopathy.

When to seek medical help?

If the pain is unbearable and seems to worsen with movement, or if it is followed by weakness in limbs or stiffness in the neck which restricts activity, it is a sign to seek medical attention.

Diagnosis

Beginning with the physical examination of the neck and lumbar region, the doctor will check abnormalities in nerve function, sensations, reflexes, muscle strength, the range of movement, changes in gait along with understanding the history of symptoms and injuries if any.

Taking the diagnosis further, the doctor will suggest imaging tests like X-ray, CT scan or MRI to trace bone spurs, pinched nerves, protruding discs regenerated facet joints, hypertrophied ligaments etc. This is followed by nerve function test.

Treatment

Depending on the cause of Spondylosis and the intensity of damage the doctor would begin with medication followed by low-intensity physical therapy and adequate rest. The therapy includes stretching neck and shoulder muscles. The doctor can also suggest few sessions of neck traction at times. Medication should generally be a combination of pain reliefs, muscle relaxants, and drugs like Gabapentin and likes for nerve relief.

Surgery

Is rarely necessary for cervical spondylosis. But is recommended in severe cases where the preliminary treatment fails and the condition gets worse. Surgery is used to remove bony spurs or the bulging disc to create space for the cord and nerves. These procedures are sometimes followed by vertebrae fusion to stabilize the spine.

  • Laminectomy is the procedure to remove the bone curvatures of the spinal canal to increase the size of the canal and reduce pressure on the cord.
  • Discectomy is to remove the bulging portion of the disc that exerts pressure.
  • Foraminotomy or foraminectomy is to expand the openings for the nerve to exit the spinal canal without compression.
  • Corpectomy is a procedure to remove a vertebral bone.

Minimal Invasive / Less Invasive Surgery Procedure

This is an advanced surgical procedure that involves an incision of barely 1 inch in the back and the surgeons use micro tools, endoscope, and indirect monitoring through a high definition monitor to perform the surgery.

Like in the case of spondylosis due to herniated discs, keyhole surgery is used to evict the bulging part or prolapsed disc. This takes less than an hour and the patient can feel instant relief. Minimal invasive surgery is used for spinal decompression to ease a compressed nerve. Bone graft screws or plates are used depending on case to hold the involved part of the spine in the place and aid in fusion. Sometimes steroid can be injected into the vertebral joint near the trigger points to manage acute pain.

Duration of surgery: If it is less invasive surgery the hospital time can be 1-3 days. In the case of the traditional procedure, the hospital time can range from 3-5 days.

Follow-up

This is necessary for the doctor to monitor the response to treatment and new symptoms. As the treatment progresses the doctor might suggest changes in physical therapy too. Imaging and scan are not usually necessary.

Cost of surgery

This depends on the cause of spondylosis and the type of surgery. In India, the cost of surgery to treat spondylosis can vary from patient to patient, the cost will include a cost of surgery procedure, hospital charges, implants and drugs. To get an estimate please contact us at info@spineandbrainindia.com

 

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