What is meant by cervical spondylosis?
The term “cervical” refers to the spinal column in the neck region. The term”spondylosis” refers to any ailment of the spine!! The term spondylosisis used loosely for all kinds of neck pain, from the purely innocuous ones to the ones those require surgical intervention. This neck pain may be in the nape of your neck, or very often may be present between the two shoulder blades.
What causes cervical spondylosis?
Cervical spondylosis can be caused by a slipped disc or a bony overgrowth or a combination of both. 1. What is a slipped disc? Our spine is made up of a number of bones called vertebrae stacked one on top of another. 2. Why does the disc slip out? Over the years, the disc develops small microscopic tears, which may unite together over a period of time such that with some trivial injury or some innocuous activity, the disc may slip out of its normal confines. As a part of the normal aging process, the spine may develop some extra bone growth, leading to compression of the adjacent spinal cord or its nerve roots leading to pain.
How does cervical spondylosis manifest?
One of the commonest complaints is neck pain that may be present either at the nape of the neck or between the two shoulder blades. This pain would generally be noted on some kind of neck movement or on coughing or sneezing. Similar to “sciatica” that occurs in the lower back, when the pain starts radiating down into the upper limbs, it is referred to as “radiculopathy”. Another complaint of cervical spondylosis is unsteadiness while walking.
Can any other condition mimic cervical spondylosis?
Any compression or problem affecting the nerves after they leave the spinal canal can also lead to pain along the hand. The most common condition that can affect the nerves after they leave the spinal canal is ‘peripheral neuropathy’, a condition wherein the nerves are ‘weakened’ secondary to diabetes, chronic alcoholism, smoking, other forms of tobacco consumption, nutritional deficiencies or other rare causes. Neck and back are often termed the mirrors of the mind. Hence, stressful periods are likely to give you some neck or back pain as well! Poor posture is also a common culprit for neck and back pain.
How does the doctor investigate for cervical spondylosis?
Commonly, plain x-rays of the spine may be ordered with or without some basic blood investigations such ashemoglobin, erythrocyte sedimentation rate [ESR], CRP, RA test, serum calcium, phosphorus and alkaline phosphatase.
Based on these tests, or sometimes, in the presence of some significant signs or symptoms, you may be asked to undergo MRI scanning. Plain x-rays demonstrate bony features, while MRI demonstrates the spinal cord, its nerve roots, the intervertebral disc between the two bones of the spine.
Is there any non surgical treatment for cervical spondylosis? The treatment would depend on the duration of your problem,Various nonoperative means of treatment include painkillers, muscle relaxants, various modalities such as heat and electrical stimulation, cervical traction, activity restrictions, etc.
When is surgery essential?
Surgery would be indicated when there is no pain relief, thus rather than asking as to what are the risks of going in for surgery, it would be more prudent to ask as to what are the risks and benefits of getting the surgery done as compared to not getting the surgery done.
How is the post operative recovery and rehabilitation?
Generally, you will be admitted one day prior to the day of surgery. You will be advised to fast after dinner the previous night. Surgery would generally be carried out the next day morning. After surgery, on the 2nd or 3rd day, you will be made to walk with a cervical collar. You may be discharged after 3-4 days. Sutures [stitches]would be removed generally on the 10th-14th day following the surgery. By this time, you will be walking around and essentially be independent in doing activities of daily life. You will be allowed to take bath 48 hours after the suture removal. For 3-4 weeks, you will be allowed restricted mobilization within the house. During this period, you will be encouraged to increase all your activities in gradual weekly increments. A month later, you will be starting with spinal strengthening exercises. You will have to use the cervical collar for about 1-3 months at all times other than while taking bath. You will not be allowed to smoke for life
What about newer advances in the treatment of this condition?
Microscope allows for the use of both eyes while working, giving binocular vision and thereby, good depth perception that is very essential for the safe performance of these surgeries. This binocular vision is lacking in endoscopic discectomy. Percutaneous laser discectomy has not been proven to be scientifically superior to microdiscectomy. Rather than doing the conventional surgery of fusion at the level of discectomy, it is possible to replace the disk with an artificial one. This would simulate normal spinal function and hence, is a better surgery than the conventional fusion. However, it is costlier than the conventional fusion surgery.
