Dr.vinod naraniwal (physio)

Treatment
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Without treatment, the signs and symptoms of cervical spondylosis may decrease or stabilize, or they may worsen. The goal of treatment is to relieve pain and prevent permanent injury to the spinal cord and nerves.

Treatment of mild cases
Mild cases of cervical spondylosis may respond to:

  • Wearing a neck brace (cervical collar) during the day to help limit neck motion and reduce nerve irritation.
  • Taking nonsteroidal anti-inflammatory drugs such as ibuprofen (Advil, Motrin, others) for pain relief.
  • Doing exercises prescribed by a physical therapist to strengthen neck muscles and stretch the neck and shoulders. Low-impact aerobic exercise, such as walking or water aerobics, also may help.
  • Treatment of more serious cases
    For more severe cases, nonsurgical treatment may include:

    • Hospitalization with bed rest and traction on the neck for a week or two to completely immobilize the cervical spine and reduce the pressure on spinal nerves.
    • Taking muscle relaxants, such as methocarbamol (Robaxin) or cyclobenzaprine (Flexeril), particularly if neck muscle spasms occur, and taking narcotic medications to relieve severe pain.
    • Injecting corticosteroid medications into the joints between the vertebrae (facet joints). The injection combines corticosteroid medication with local anesthetic to reduce pain and inflammation.

    Illustration showing laminectomy          Surgery
    Your doctor may recommend surgery to relieve compression of spinal nerves or the spinal cord if you have severe pain that doesn't improve with more conservative treatment or if your neurological symptoms, such as weakness in your arms or legs, are getting worse. The surgical procedure will depend on your underlying condition, such as bone spurs or spinal stenosis. The most common surgical options include:

    • Frontal approach (anterior). Your surgeon makes an incision in the front of your neck and moves aside the windpipe (trachea) and swallowing tube (esophagus) to expose the cervical spine. Your surgeon can then remove a herniated disk or bone spurs, depending on the underlying problem. Sometimes, with disk removal, your surgeon will fill the gap with a graft of bone or other implant.

      With the anterior approach, your surgeon can relieve pressure on your spinal cord from bone or more than one disk by removing two disks and the bone between them (corpectomy). Then, to support your head and neck, your surgeon reconstructs the area with bone from your body or a bone bank or with an implant made of metal combined with bone.

    • Back approach (posterior). Your surgeon may opt to remove or rearrange bone from the back of your neck, especially if several portions of the channel that houses the cord have narrowed. Your surgeon makes an incision at the back of your neck and removes the back part of the bone over the spinal canal (laminectomy). Or your surgeon may cut the bones in several places and rearrange them to make more room for the spinal cord (laminoplasty).

      Laminoplasty may require more time in surgery, but it preserves stability of the cervical spine. Laminectomy may leave the neck unstable. In some cases, a surgeon may connect two or more vertebrae (fusion), which stabilizes the spine but causes stiffness and permanent loss of movement. Fusion may involve bone grafts and the use of wires, rods, screws or plates to hold the spine in place.

    Risks of surgery
    Risks of these procedures include infection, a tear in the membrane that covers the spinal cord at the site of the surgery, bleeding, a blood clot in a leg vein, and neurologicaldeterioration. In addition, the surgery may not eliminate all the problems associated with your condition.

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Dr.vinod naraniwal
dr_vinod_pt@yahoo.com