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Spondylosis is degenerative arthritis (osteoarthritis) of the spinal vertebra and related tissue. If severe, it may cause pressure on nerve roots with subsequent pain or paresthesia in the limbs.
When the space between two adjacent vertebrae narrows, compression of a nerve root emerging from the spinal cord may result in radiculopathy (sensory and motor system disturbances, such as severe pain in the neck, shoulder, arm, back, and/or leg, accompanied by muscle weakness). Less commonly, direct pressure on the spinal cord (typically in the cervical spine) may result in global weakness, gait dysfunction, loss of balance, and loss of bowel and/or bladder control. The patient may experience a phenomenon of shocks (paresthesia) in hands and legs because of nerve compression and lack of blood flow. If vertebrae of the neck are involved it is labelled cervical spondylosis. Lower back spondylosis is labeled lumbar spondylosis.
[edit] Treatment
"Treatment is usually conservative in nature; the most commonly used treatments are nonsteroidal anti-inflammatory drugs (NSAIDs), physical modalities, and lifestyle modifications. Alternative therapies such as osteopathic manipulative medicine (OMM), massage, trigger-point therapy, chiropractic and acupuncture may be utilized to control pain and maintain musculoskeletal function in some people. Surgery is occasionally performed. Many of the treatment modalities for cervical spondylosis have not been subjected to rigorous, controlled trials. Surgery is advocated for cervical radiculopathy in patients who have intractable pain, progressive symptoms, or weakness that fails to improve with conservative therapy. Surgical indications for cervical spondylosis with myelopathy (CSM) remain somewhat controversial, but "most clinicians recommend operative therapy over conservative therapy for moderate-to-severe myelopathy." (Baron, M.E.) Physical therapy may be effective for restoring range of motion, flexibility, and core strengthening. Decompressive therapies (i.e. manual mobilization, mechanical traction) may also help alleviate pain. However, physical therapy cannot "cure" the degeneration, and some people view that strong compliance with postural modification is necessary to realize maximum benefit from decompression and flexibility rehabilitation. Understanding anatomy is the key to conservative management of spondylosis.
[edit] Surgery
There are many different surgical procedures to correct spinal deformity. The vertebrae can be approached by the surgeon from the front, side, or rear. Portions of a disc may be removed. To prevent further dislocation, fusion of two vertebrae may be done by taking pieces of bone from the patient's hip and inserting them between the two vertebrae which are fused together and secured by screws.
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