Spondylosis is a degenerative condition affecting the bones and joints of the spine. The exact cause is unknown, but it is thought to be a result of the aging process. Joints, ligaments, and intervertebral discs “wear down” and undergo changes that disrupt normal spinal structure and function.
The degenerative process usually begins in the disc. With advancing age, discs can lose water content, causing them to erode or collapse. Loss of the protective cushion between the vertebrae results in bone rubbing against bone. This can cause excessive wear and tear on adjacent spinal structures, leading to the development of bony spurs (osteophytes). As the condition progresses, osteophytes can exert pressure on the spinal cord, compress spinal nerves and restrict joint movement. Advanced spondylosis can also cause thickening of the spinal ligaments, contributing to nerve compression and pain.
Spondylosis, osteoarthritis, and degenerative joint disease are often used interchangeably, but are distinct conditions (but may occur together). Spondylosis is a debilitating condition that can affect any region of the spine, although it most commonly occurs in the neck (cervical) or lower back (lumbar).
Symptoms
Symptoms of spondylosis will vary, depending on the area of the spine affected. Pain and stiffness are common. Alterations in spinal alignment may cause nerve compression and deformity. Over time, widespread degenerative changes lead to spinal instability. Symptoms commonly associated with spondylosis include:
- Back pain/stiffness, especially upon awakening
- Difficulty bending over
- Numbness, weakness in the buttocks/legs
- Gait abnormalities
- Loss of bowel and/or bladder control (uncommon)
Treatment
Surgery is not always required to treat spondylosis. Non-surgical care targets condition management and relief of symptoms. Typical interventions include:
- Medication
- Physical therapy
- Bracing
Most patients respond well to a multidisciplinary treatment approach that includes medication and physical therapy. For patients with persistent pain, epidural steroid injections may provide relief for up to 6 months.
If non-surgical treatments fail or pain becomes unrelenting, surgery may be recommended. Decompression surgery involves the removal of tissue or bone to relieve pressure on the nerves. In cases of spinal instability, spinal fusion is often the best treatment option. Early and appropriate treatment is key to managing this disorder and minimizing loss of function.