What is spondylosis?
Spondylosis is an overview term that refers to spinal degeneration, typically in the form of bone spurs or degenerating discs between vertebrae. Spondylosis can be referred to osteoarthritis of the spine, which is general wear and tear affecting the spinal discs.
Although spondylosis is very common, most people do not experience symptoms. If symptoms do arise, they are usually treated with nonsurgical treatments.
Spondylosis can occur in the cervical spine (neck), thoracic spine (upper to middle back) or lumbar spine (lower back).
Causes of spondylosis
Spondylosis most commonly occurs as a result of the day-to-day stress and strain over time on the body. As you age, your joints and spine structures are degenerating. Spondylosis affects the lumbar spine more frequently than it affects the cervical or thoracic spine. Conditions associated with spondylosis include:
- Herniated or bulging discs
- Spinal stenosis
- Bone spurs
- Degenerative disc disease
Risk factors for spondylosis
Risk factors for spondylosis include:
- Age — most people (more than 85 percent) are over the age of 60.
- Genetics — if you have a family member with spondylosis, you are more likely to develop the condition as well.
- Injury — patients who have had previous spinal injuries are at greater risk of developing spondylosis due to the increased likelihood of osteoarthritis in injured joints; spondylosis can occur years after the spine was injured.
Symptoms of spondylosis
Many people do not experience symptoms related to spondylosis. When symptoms occur, they vary based on the location of the spondylosis.
The most common symptoms of cervical spondylosis are neck pain and stiffness.
Symptoms of thoracic spondylosis include:
- Mid back pain and stiffness — most common in the morning when you wake up
- Numbness or tingling in the extremities (legs, arms, hands or feet)
- Muscle weakness in the lower back
- Difficult walking
- Lack of coordination
Symptoms of lumbar spondylosis include:
- Low back pain
- Muscle spasms
As the condition worsens, your symptoms may intensify. Patients with mild lumbar spondylosis may only notice minor symptoms like hamstring tightness or inability to touch your toes.
Diagnosis for spondylosis
Spondylosis can be diagnosed in a physical exam with a primary care or spine specialist. During the exam, your doctor will evaluate your symptoms, take a full medical history, perform some movement and reflex testing and order diagnostic imaging testing. Imaging testing to confirm your diagnosis may include:
- X-ray — an x-ray scan can produce images that indicate the presence of bone spurs or inflammation in the facet joints.
- CT (computed tomography) scan — a CT scan can take detailed x-ray images from many angles to give your physician a cross-sectional view of the spine and surrounding structures.
- MRI (magnetic resonance imaging) scan — an MRI scan produces detailed images of the spinal structures to reveal any degenerating vertebrae or facet joints.
Treatment for spondylosis
Most patients can experience symptom relief from nonsurgical treatment options such as medication, rest and physical therapy. Your doctor will monitor your progression, and if your symptoms are not improving or worsening, you may need surgical intervention.
- Medications — over-the-counter anti-inflammatory medications are a first-line therapy for mild spondylosis; if these medications are not effective, prescription medications may be needed.
- Physical therapy — physical therapy, under the guidance of a certified physical therapist, can help strengthen the muscles around the spinal cord.
Patients who are experiencing any of the following symptoms/conditions may need spinal surgery:
- Bowel or bladder dysfunction
- Spinal stenosis
- Neurological dysfunctions
- Unstable spine
For most patients who require surgery, surgery occurs in two parts, removing what is causing the symptoms (decompression surgery), followed by spinal fusion (stabilization surgery).
Decompression surgeries to treat spondylosis can include:
If the facet joints put pressure on your nerves, you may need surgery to remove the facet joint to relieve the pressure.
During a foraminotomy procedure, your surgeon will enlarge the opening where the nerve exits the vertebra. The goal of this procedure is to relieve pressure on the nerve so the nerve can exit without being compressed by a bone spur or disc.
If the plate on the back of the vertebra that protects the spinal canal and cord is pressing on the spinal cord, it may need to be removed to relieve your symptoms.
During a laminotomy procedure, your surgeon will relieve the pressure on the nerve structure by creating a larger opening in the lamina (the bony plate that protects the spinal canal and spinal cord).
A corpectomy, also called a vertebrectomy, is a surgery that removes part of the vertebrae when bone spurs form between the vertebrae and spinal cord compressing the nerves.
After decompression surgery, your surgeon will perform stabilization surgery to fuse the spine together. Spinal fusion surgery is typically the procedure performed to stabilize the spine. Spinal fusion can be done from the back, from the front or from the side.