SPONDYLOSIS: Causes, Symptoms & Treatment

August 9, 2020 by Dr Arun Saroha0
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SPONDYLOSIS

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 seem as early as 20 years of age. Spondylosis has affected over 80% of people above the age of 50 Globally. It 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 is 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 roughness 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 causes sciatica.
  • Any past injury or accident trauma that might have affected the neck or lower back can render the bones 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 heavyweight or a continuous repetitive movement of the back cause wearing out of the bones that have been exerted the most. Heavy weight lifting in the gym over time can cause spinal wear and tear.

SpondylosisSymptoms

This can occur in the cervical spine (neck region), middle back or the lumbar spine (lower back). Common signs are stiffness in neck or headaches.

Symptoms include:

  • A 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 a sharp shooting pain that increases with movement. The other symptoms then are similar to that of a slipped 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 the shoots down the thighs to behind the knees and sometimes can go lower to the calf muscles. It is called radiculopathy.

When to seek medical help?

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

Diagnosis

Beginning with a physical examination of the neck and lumbar region, the doctor will check abnormalities in nerve function, sensations, reflexes, muscle strength, 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 or protruding discs. A nerve function test follows this.

Treatment

Spondylosis treatments

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. A doctor can also suggest few sessions of neck traction, where weights are used on the neck to increase cervical space and relieve the pressure on the cord or nerves. Medication should generally be a combination of pain reliefs, muscle relaxants, and anti-epileptic drugs for nerve relief. Acupuncture is another alternative therapy to treat spondylosis in the initial stage.

Surgery

Is rarely necessary for cervical spondylosis. But where the preliminary treatment fails, and the condition gets worse, it recommended in severe cases. To eject bone spurs or the bulging disc, and to create space for the cable and nerves doctors to surgery. Sometimes to stabilize the spine, vertebrae fusion follows this procedure.

  • 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.
  • Osteophyte is the removal of bone spurs that pinch nerves.
  • Corpectomy is a procedure to remove a vertebral bone and discs.

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, to evict the bulging part and repair the disc keyhole surgery is use. This takes less than a day and the patient can feel instant relief. To ease a compressed nerve, minimally invasive surgery is vital for spinal decompression. Bone graft and screws or plates to hold it in place and support the spine. To control critical pain, doctors can insert in the vertebral bone near the trigger points of the patient.

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

Follow-up

This is necessary for the doctor to monitor the response to treatment and the onset of any case of sciatica. As the treatment progresses the doctor might suggest changes in physical therapy too. Imaging and scan is not necessary.

Cost of Spondylosis surgery

This depends on the cause of spondylosis and the type of surgery. In India, the cost of surgery to treat spondylosis can range from 2.5 lacs to 4 lacs which includes the cost of surgery procedure, hospital charges, and doctor consultation.


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About Dr. Arun Saroha


Dr.Arun Saroha is working as Neurosurgeon with a special interest in spine surgery for the last 15 years. He specializes in Neuro-oncology, Paediatric Neurosurgery, Neurotrauma, Stroke & Cerebrovascular surgery including Transnasal surgeries. He has also been performing instrumented/ Non-instrumentation spine surgeries, including minimally invasive spine surgeries. He has performed more than 6,000 Neurosurgeries (Spine and Brain) successfully till date with patients from all over the world.

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