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Spondylosis (Arthritis of the spine)

Spondylosis is the equivalent of Osteoarthritis of the knee joint. This is a degenerative condition where the bones that make up the spine (vertebrae) degenerate. Typically this degeneration forms bony projections (bone spurs) and reduces the height of the spongy discs between the vertebrae.

Spondylosis can affect the neck (cervical spine), upper, mid and lower back (thoracic spine and lumbar spine). The most common area affected is that of the lumbar spine and cervical spine.

Spondylosis is due to:
1.Age, which leads to wear and tear of spinal ligaments and bones
2.Weakened and degenerated intervertebral discs
3.Spinal cord injury
4.Genetic predisposition

WHAT ARE THE COMMON SYMPTOMS OF SPONDYLOSIS?

The signs and symptoms of spondylosis include:
1.Back and neck pain due to nerve compression
2.Numbness and tingling of arms and legs
3.Muscle spasms/cramps, referred to as claudication
4.Sciatica (low back pain extending down the leg)
Sometimes Incidental Xrays may show spondylosis, but patient may not show any symptoms. It is hence wise to consult your doctor and confirm the clinical relevance of the Xray findings.

Along with clinical examination, Xrays and if required MRI scans are needed to confirm the diagnosis. A special flexion-extension lateral view maybe needed to identify any associated instability of the spine. Nerve Conduction study maybe needed to confirm the diagnosis in some cases.

Non-surgical treatment is usually tried for most cases first and includes:
1.Adequate rest and activity restriction
2.Heat and/or ice therapy to lessen the pain
3.Special cervical pillows to relieve neck pain while sleeping
4.Exercises to strengthen your back and stomach muscles.
5.Regular walking and yoga
6.Chiropractic spinal manipulations- to correct the spinal alignment and improve your body’s function.

1.Guided steroid injections
2.Radiofrequency denervation
3.Spine decompression – Microdiscectomy
4.Spine decompression-Laminectomy
5.Spine decompression and Fusion
6.Spine decompression and Instrumentation
The nature of surgery depends on the clinical, Xray and MRI findings for each patient.

A good suitable mix of Steroids and Local Anaesthetic agents may be injected into facet joints (joints between adjacent vertebrae), epidural space (space around the spinal cord), or intervertebral disc spaces based on clinical examination, to reduce acute pain and pain radiating into a limb. This may need repetition at a later date.

Radiofrequency denervation is a technique wherein the nerves causing pain are detected and treated, to stop the transfer of pain messages. A radiofrequency probe is used to target the affected site. It wirks on the principle of converting electrical energy into thermal energy.