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Arthritis of the neck,
cervical osteoarthritis, or degenerative joint disease of the
neck.
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- Cervical spondylosis is a
degenerative process that affects the cervical spine.
- Cervical spondylosis is a condition
that mainly affects older people, usually over 40. Men are
affected more than women. This condition results from
degenerative changes that occur in the cervical spine (the
part of the spine in the neck). Over time, the degenerative
changes lead to changes in the vertebra. This can then cause
nerve compression or inflammation.
- Symptoms depend on the location of
the nerve compression, but can include pain, numbness,
weakness, headaches, urinary problems, etc. Treatment is
usually with medications and use of a cervical collar.
However, if this fails, then surgery may be necessary.
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- Initially the person may not have
any symptoms.
- Others will have neck or shoulder
pain, headaches in the back of their head, or stiffness of
the neck. They may have difficulty turning or bending their
neck from side-to-side.
- Some will have pain that shoots
down a certain part of the arm. They may also notice
numbness, weakness, or pain in the arm. One or both sides
may be affected. Often it causes the hands to become clumsy.
- Some individuals will have numbness
or weakness in their legs. Many with this condition will
have decreased vibration-sense in their legs. They may be
unsteady while walking. In fact, spondylosis is a fairly
common cause of unsteadiness in the elderly.
- Others will have a specific level
on the chest or abdomen where there is a noticeable change
in sensation.
- Problems with urination may occur.
Some will have to urinate more often, while others will have
to urinate urgently. A few will develop urinary
incontinence.
- The symptoms may get worse with
turning, extending, or bending the neck. In others, coughing
or straining may temporarily cause shooting pain in the arms
or shoulders or it may worsen weakness in the legs.
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- Cervical spondylosis is caused by degenerative changes that occur in the cervical spine over time. This can lead to a herniated disc, Calcium build-up
within the disc, or bony growths on the spine.
- These changes can then cause certain nerves to become
pinched, compressed, or inflamed.
- Also, depending on which way the disc herniates or the
direction of the bony growths, there is a possibility that
the spinal cord could be compressed.
- There is also the possibility
that the blood flow to certain nerves may be affected.
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- Physical exam may reveal numbness
or pain along a certain nerve distribution. Certain muscles
may be weak and the reflexes not as brisk as normally. The
affected individual may have difficulty with turning the
neck or bending it from side to side. The arms or legs may
be stiff. The hands may be weak and the muscles of the hands
atrophied.
- X-Rays - can be helpful in making the diagnosis. However, though X-Ray findings of degenerative changes are often found in many older people, only a few will truly evidence the neurological changes caused by this condition. Alone, finding degenerative changes on X-Rays is not conclusive but
part of an overall determination of this condition that must
take into consideration other factors.
- CT scan - can be used to look at
the spinal column and see if there is any narrowing or other
abnormality.
- MRI - can also be used to look at
the spinal column and see if there is any narrowing or other
abnormality.
- Nerve conduction studies and Electromyography can
be done to test the nerves and muscles.
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- Risk factors include any
degenerative process that may affect the cervical spine.
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- The primary treatment for this
condition is to restrict neck movements. This is usually
done with a cervical collar. If a cervical collar is not
sufficient, then a more rigid brace for the neck may be
necessary.
- If that does not work, then surgery
to decompress the nerve and stabilize the neck may be
necessary. Surgery is usually done if:
- Conservative measures such as a
cervical collar do not work.
- There is severe pain.
- There are significant neurologic
deficits, such as difficulty walking, severe hand
weakness, or bladder problems.
- There is compression of the
spinal cord.
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- With any nerve condition, if it is
not treated early, there is a danger that the loss of nerve
function may be permanent. Nerves are very delicate. Once
they are injured beyond a certain point, they do not
recover. Therefore, the symptoms that can be caused by this
condition could become permanent if not treated
appropriately (i.e., numbness, weakness, urinary
problems).
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- Seek medical attention.
- If there is a sudden onset of
numbness or weakness, then you must seek medical attention
immediately. If the nerve damage is severe, delay in
treatment may result in permanent loss of function.
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- There is no specific way to prevent
this condition. However, good posture should be maintained.
- Also, avoid repetitive injuries to
the neck and cervical spine.
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- Amyotrophic lateral sclerosis
- Multiple Sclerosis
- Subacute combined degeneration
- Cervical strain
- Spinal cord tumors
- Cervical rib syndrome
- Brachial plexus neuropathies
- Acute cervical disc herniation
- Syringomyelia
- Ankylosing Spondylitis
- Atlantoaxial subluxation
- Tropical spastic paresis
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