Spine is an important part of the central nervous system. Spondylosis means ageing of the vertebra. As age advances, our body undergoes various changes as a result of wear and tear over the years. As we age, our hair turns grey, skin texture changes and our vision diminishes. Similarly, spine goes through stress and pressure leading to degeneration with age. This age-related condition which affects the joints and discs of our spine involving the back and neck is known as Spondylosis.
While the condition is characterized by pain, stiffness, numbness, weakness due to change in the spine due to ageing of the spine. Spondylosis is a non-inflammatory change around vertebrae and intervertebral disc and causes abnormal bone growth and reactive osteoarthritis in joints like facets which lead to limited mobility of the spine. This can impair the dynamic function of the spine and compromises the spinal cord or nerve functions.
In the initial stages it may be treated completely, once permanent damage occurs, it may be difficult for the spine to recover. Early diagnosis and proper treatment of spondylosis is all the more essential.
What Are the Different Types of Spondylosis?
The type of spondylosis varies depending upon the affected region. However, not all cases are harmful and require addressing. Wear and tear is natural and while our body is designed to withstand gradual damage. Most common affected regions are lumbar region and cervical region. It can occur in the dorsal region also.
Cervical spondylosis affects the upper 1/3 of the spine in the neck region. The most common symptom is neck pain and pain in the shoulder blades and hands, which may be in one or both sides. Neck pain and limbs pain can affect the daily activities. As the condition worsens, it can cause stiffness in the hands and limbs. People are unable to grasp objects with their hands and also experience tingling or numbness in their arms and hands, movement of hands and legs will be difficult.
Lumbar spondylosis affects the lower 1/3 of the spine. The lumbar region is the lower back area when affected, there may be lower back pain, pain in legs and tingling sensation or numbness. Later stages may involve difficulty in walking and weakness in the foot. If the condition worsens, if cauda equina nerves are affected they may lose bowel and bladder control.
How Is Spondylosis Diagnosed?
Degeneration of the spine may begin in the 30’s or earlier but worsens as our age advances. A neurological examination is the most basic part. It involves the evaluation with detail history analysis, neurological assessment involves motor and sensory system examination and reflexes responses.
With a neurological examination, many cases require a deeper insight which is gained through neuroimaging, including X- Rays, MRI and CT Scans to directly or indirectly obtain a visual representation of the structure and functioning of the nervous system. Neuroimaging is vital in diagnosing complications and conditions which arise as a result of Spondylosis, cervical as well as lumbar such as
- Spinal Disc Prolapse:
It is the herniation (damage and injury) of the disc that is cushioning or shock absorber tissue between the vertebrae of the spine, usually occurs as a result of excessive, repetitive pressure and strain on the spine.
- Spinal Stenosis:
It is the age-related narrowing of the space within the spinal canal and also between the vertebra which leads to compression and pinching of the nerves, causing chronic pain and claudication pain and restriction of movement.
It is the displacement and slipping of the vertebrae in the spine. The forward or sideways slip of one of the 33 vertebrae is a threatening and extremely painful condition.
- OPLL (Ossified Posterior Longitudinal Ligament):
A condition in which the posterior longitudinal ligament which connects and strengthens the spine and the vertebrae right from the cervical area (neck) to the lower back becomes hard and thickened leading to narrowing of the spinal canal causing reduced flexibility, movement and stiffness and weakness in the limbs.
It is recommended that individuals over 50 years and above get themselves checked on an annual basis to identify potential consequences due to spondylosis early.
How Is Spondylosis Treated?
Spondylosis is classified on the basis on the severity of pain, into three categories-Mild, Moderate and Severe. Usually, mild to moderate cases are cured by medical management (medication for pain relief) and neuro spinal physiotherapy which adequately strengthens the affected region and helps develop flexibility by slowly and gradually exercising and practising. However, moderate to severe cases require careful consideration and reexamination. If the regular conservative treatment is unable to reduce pain, further neuroimaging is undertaken, and a neuro-spine surgery is advised to prevent the further aggravation of pain and neurological impairment. It will prevent the further problem to the spine and the body.
Precautions And Risk Factors To Be Aware Of:
The importance of the spine and the back cannot be stated enough. Not only does the spine forms the physical backbone of our body but also plays a key role in our nervous and psychological systems. Therefore, it is essential to not take any risks with respect to medical issues involving the spine and the neck. Every patient and individual afflicted by spinal conditions must identify the risk factors and take extreme care to get them cured and thereby prevent complications, further damage and degradation. Aerobics, cycling and maintaining proper posture are some factors that can help strengthen the spine.
Risk factors which must be kept in mind when dealing with neuro spinal conditions are:
- Repetitive movements of the neck and back as well as sudden and exaggerated motions.
- Stress on the back and spine due to heavyweights and pressure.
- Ergonomics - Poor posture as a result of constant desk jobs, laptop use, mobile phones etc. is one of the leading causes for a whole host of back and neck conditions like text neck.
- Smoking causes the release of toxic substances which are harmful to the spine and it leads to premature ageing of the spine.
- Mattress- It is always better to invest in supportive mattress for complete relaxation of the spine.
- Any other factor, which vary from individual to individual such as obesity, arthritis, previous spinal or cervical injuries and even depression predispose to spinal issues, and they need to be addressed and treated adequately.
People display a tendency to tolerate minor pains and discomforts and attempt to get through the pain barrier and get on with their daily lives, which can often be a huge risk. At the slightest hint of pain which lasts beyond a couple of days and if experiencing repeated discomforts, always get yourself checked rather than allowing it to turn into a worse condition.
- By Dr. Ganesh Veerabhadraiah, Senior Consultant, Neurosurgery, Fortis Hospital, Cunningham Road, Bengaluru