Spondylosis is a nonspecific term that denotes arthritis of the spine. Cervical spondylosis refers to an arthritic process in the neck, while lumbar spondylosis refers to an arthritic process in the low back. The spine is divided into three segments including the cervical spine (neck), the thoracic spine (spine attached to the rib cage) and the lumbar spine (low back). It is unusual to see thoracic spondylosis because the rib cage affords a stabilizing influence to the thoracic spine, making arthritis less likely.
Neurosurgeons manage spondylosis when it produces symptoms, most commonly discomfort related to compression of a nerve or the spinal cord. Compression of a cervical nerve can result in pain in the shoulder blade and down the arm, or numbness, tingling, and weakness in the arm. Compression of a lumbar nerve can result in buttock and leg pain, or in numbness, tingling, or weakness in the leg. Compression of the spinal cord can result in symptoms of balance and coordination issues.
Testing for spondylosis usually involves a thorough interview and neurological examination in addition to imaging. The most common imaging techniques include X-rays, an MRI or a CT scan.
If indeed an individual has spondylosis findings on imaging that correlate with his or her symptoms, there are several treatment options. We tend to treat this problem nonsurgically if possible, commencing with physical therapy or anti-inflammatory medication. If the spondylosis symptoms are more troublesome and do not respond to these measures, other therapies can be considered including steroid administration to the irritated nerve root (epidural steroid injection) or even microsurgery as a last resort.
The success rate for treatment of spondylosis tends to be quite good if there is a correlation between the nerve pain symptoms and the imaging. If there is a correlation between the presenting pain symptoms and compression of a nerve, surgical success rates are at least in the 80% range.