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Highlights & Basics
- Degenerative cervical spine disease (cervical spondylosis) is osteoarthritis of the spine, which includes the spontaneous degeneration of either disk or facet joints.
- Patients typically present with axial neck pain. Most commonly the degeneration is asymptomatic, even though cervical radiographs and magnetic resonance imaging (MRI) may show severe, spontaneous degenerative disease. Neurologic complications can occur if the degeneration includes neurologic compression.
- Neurologic complications are common in patients with degenerative cervical spine disease; these include cervical spondylotic radiculopathy, with nerve root compression, and loss of neurologic function from pressure on the spinal cord (degenerative cervical myelopathy). Cervical radiculopathy involves typically only a single nerve root territory, whereas cervical myelopathy can cause more diffuse sensory loss, weakness, and reduction or loss of function in the upper (and sometimes lower) extremities.
- Treatments differ radically depending on patient presentation, specific symptoms, and whether arthritis-related pain or neurologic complications predominate.
- Neurologic complications may respond to surgical decompression if symptoms do not abate after treatment with conservative measures, depending on their longevity and severity.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Images
Severe, multilevel degenerative disk disease changes but without significant spinal cord compression (i.e., neither deformation nor intrinsic T2 changes) on cervical MRI (sagittal T2)
Cervical MRI (sagittal T2) with mild degenerative joint disease and disk bulging
Cervical MRI (sagittal T2) with moderate degenerative joint disease but no significant spinal cord compression
Diagram of subsets of cervical spondylosis, including various symptoms possibly arising within the larger field of asymptomatic (radiographic) spondylosis
A single level of spinal cord compression with T2 changes, on cervical sagittal T2 sequence in the presence of symptomatic degenerative cervical myelopathy
Previous spinal cord compression at C3/4 on sagittal T2 MRI, with residual T2 changes, and new compression at C2/3 and C6/7, with T2 changes
Chart showing average dermatome size and location. Radicular pain is usually confined to a single dermatome
Citations
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American College of Radiology. ACR appropriateness criteria: cervical neck pain or cervical radiculopathy. 2024 [internet publication].[Full Text]
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