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Spondylosis

Spondylosis and Spondylolisthesis

Our backbone or spine is made up of 26 bone discs. They are called vertebrae, whose essential function is to protect the spinal cord and allow us to stand and bend. A number of problems can affect its structure, damaging the vertebrae and the surrounding tissue.  Some common problems include:

  • Infections
  • Injuries
  • Tumors
  • Bone changes due to aging

Common symptoms of spinal diseases include pain and limited motion. The standard treatment, depending on the disease, may involve medication, pain relief, physiotherapy, surgery and back braces.

Spondylopathy is the general medical term for disorders of the vertebrae. The term belongs to a wider category that refers to spinal diseases, known as dorsopathy (conditions impairing the backbone). This parental category includes four types of spine diseases, namely:

  • Deforming dorsopathies such as spinal curvature – kyphosis, lordosis, scoliosis, Scheuermann’s disease and torticollis
  • Spondylopathy, which can be:
    • Inflammatory – spondylitis, sacroiliitis, discitis, spondylodiscitis, pott disease
    • Noninflammatory – spondylosis, spondylolysis, spondylolisthesis, spinal stenosis, facet syndrome
  • Back pain – Neck pain, upper back pain, low back pain (coccydynia and sciatica), radiculopathy
  • Intervertebral disc disorder – Schmorl’s nodes, degenerative disc disease, spinal disc herniation

In this article we will focus on spondylosis and spondylolisthesis, which fall into the category of non-inflammatory spondylopathy.

Cervical Spondylosis

When the spinal disks in the neck are affected by age-related wear and tear, and the disks dehydrate and shrink, osteoarthritis develops, causing a number of problems:

Pain and stiffness becomes constant as the space needed by the spinal cord and the nerve roots is narrowed. When nerves get under pressure, tingling sensations, lack of coordination, difficulty walking and loss of bladder control can occur.

In this case, the most effective cervical spondylosis treatment is surgery. If not treated in time, damages can be permanent.

Some other common causes for cervical spondylosis are:

  • Stiff ligaments – due to calcification
  • Bone spurs – due to disk degeneration, the spinal cord and nerve roots are pinched.
  • Herniated disks – due to crack in the exterior of the disks.
  • Dehydrated disks – due to bone-on-bone contact between vertebrae.

Cervical Spondylosis Treatment

Imaging tests provide detailed guides for diagnosis and treatment.

Some common imaging tests include:

The doctor will also check the range of motion, find out where the pressure is centered, test reflexes and strength of the muscles.

Cervical spondylosis treatment options are:

  • Medications – pain relievers and:
    • Muscle relaxants
    • Anti-seizure drugs
    • Narcotics
    • Steroid injections
  • Therapy – will help reduce pain using stretches and exercises to make the neck muscles stronger.
  • Massage therapy involves acupuncture, yoga, chiropractors and osteopathic doctors.
  • Surgery – permanently alleviates the pain and discomfort.

Similar conditions include:

  • Lumbar spondylosis – also known as spinal osteoarthritis affecting the lumbar area of the spine. Lumbar spondylosis is also a degenerative disorder that results in the loss of normal spine function.
  • Lumbosacral Spondylosis – a basic term to describe age-related degeneration in the lower back, where the last vertebrae of the lumbar spine and the first vertebrae of the sacral spine connect. It is especially prone to deterioration because it supports large amounts of weight during your lifetime.

Spondylolisthesis

This type of spine problem refers to the displacement of a vertebrae occurring most commonly in the lumbar spine. It can be caused by fracture of the pars interarticularis (spondylolysis), but should not be confused with slipped disc, in which one of the discs has ruptured.

Spondylolisthesis can be divided into five sub-categories:

  • Isthmic – a slip or fracture of the intravertebral joint
  • Degenerative – a result of facet arthritis
  • Traumatic – results from acute fractures
  • Pathologic spondylolisthesis – associated with metabolic bone disease
  • Dysplastic – a rare congenital condition due to malformation of the lumbosacral junction

Spondylolisthesis surgery is the ultimate line of treatment for this spine problem. Physical therapy, pharmacological intervention and activity modification are suggested before spondylolisthesis surgery is considered.