As we age, the joints in our necks show signs of wear and tear and this can lead to changes in the neck vertebrae as the body adapts to joint damage. Another term for osteoarthritis of the neck is known as cervical spondylosis.

Cervical Spondylosis

Symptoms for Cervical Spondylosis

The symptoms of cervical spondylosis are variable. If you have this condition, you may find your neck has gotten stiffer over time, though the onset of symptoms can also be quite sudden. The pain may be in the neck itself, between or over the shoulder blades. If a nerve is pinched, pain and / or pins and needles can be felt from the shoulder down as far as the fingers.

You may feel numbness in your shoulders and arms and rarely, the legs – in which case you need to seek medical advice promptly. Sometimes symptoms are worse after standing or sitting (especially in a draft), or in the morning if you slept in an awkward position, when you sneeze, cough, or laugh, or bend your neck backward.

Discomfort can be mild, or you may have pain so severe that you cannot move your head. You may have attacks of vertigo if you move your head quickly. The symptoms can be constant, or you may have flare-ups. In all cases get medical advice.

Some people in whom X-rays reveal the presence of cervical spondylosis exhibit no symptoms at all.

What Causes Cervical Spondylosis?

Age is not the only cause of wear on the bones and soft tissues of the neck. Years of regular sporting activities or doing a physical job that has placed stress on the neck can have the same effect.

There are several other risk factors for cervical spondylosis. These include being overweight and lack of exercise, a past neck injury – sometimes many years before – previous spinal surgery, a damage intervertebral disc, and the effects of osteoporosis.

Prevention to Cervical Spondylosis

It’s hard to avoid the stresses and strains of everyday life that contribute to the development of cervical spondylosis. But you can reduce the impact by paying attention to the posture and lifestyle.

Fixing Cervical Spondylosis

It’s important to keep your neck gently moving so it does not stiffen up. Oral anti-inflammatories may help and the doctor may give you something more powerful on an occasional basis for flare ups.

Your doctor may recommend physiotherapy which can bring relief of symptoms to some people.

Cervical Spondylolisthesis

Sometimes a condition called spondylolisthesis can be a complication of cervical spondylosis. When it occurs in the neck, the condition is often termed subaxial subluxation. One of the vertebrae slips forward (if it slips backward the condition is called retrolisthesis) so it’s out of line with the rest of the spine. This may happen because of progressive degeneration or due to trauma such as a motor vehicle collision. If the slippage is slight, you may not experience any symptoms. But if the misaligned vertebra presses against a nerve, the pain can be severe and you may have tingling or numbness in the arms and / or legs.

What is the Treatment for Cervical Spondylolisthesis

The treatment for spondylolisthesis is initially the same as for cervical spondylosis. But if things do not settle down, you may need a surgery. Fusion of the vertebrae around the area of slippage is an option that if often recommended, especially when there are symptoms of nerve compression. In some cases the vertebrae are fused where they are after the slip.

Cervical Spondylolisthesis Specialist

Dr Mathew Tung

Dr Mathew Tung Neurosurgeon

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There are three types of spinal curvature: kyphosis, in which the spine of the upper back tilts forward; scoliosis, in which the spine curves either to the left or right; and lordosis, when the lower back arches outward. Such problems can either be present at birth or develop later.

Kyphosis

Many people have a small amount of forward rounding of their upper back, but doctors don’t usually consider the problem to be kyphosis unless the degree of rounding is greater than 40 degrees. If the cause of kyphosis is long-standing poor posture or an underlying disease process, the degree of rounding is likely to increase and may cause painful symptoms.

Symptoms

When kyphosis is severe, symptoms may include not just a rounded back but also backache and some breathing difficulties. This last symptom is because the forward tilt of the spine pushes the ribs in toward the lungs and constricts their ability to expand.

What Causes Kyphosis?

When a curvature is present at birth, it’s likely that it’s been caused by a rare developmental problem that fused or distorted the baby’s vertebrae. Kyphosis may also develop during adolescence, especially in girls, when slouching posture stretches the ligaments that support the spine. Scheuermann’s  disease, a condition of unknown cause that runs in families and affects more boys than girls, may have the same effect. When kyphosis develops in adulthood, it is usually due to another condition, through poor posture also plays a part. The culprits may be osteoporosis, which sometimes leads to a dowager’s hump; osteoarthritis; rheumatoid arthritis; and ankylosing spondylitis. Occasionally, disorders that affect muscles and connective tissue or tumours may also be responsible.

Prevention

Good posture is vitally important, especially during late childhood and adolescence, so encourage your children to adopt a correct posture. For adults, physiotherapy may be useful. If you think you’re developing kyphosis, consult a doctor.

Scoliosis

Scoliosis Bending Down

While kyphosis is an outward and upward curve of the thoracic spine, scoliosis is a spinal curve in a different plane – either right or left of a normal spine, as seen from behind. In the classic manifestation of scoliosis, the spine comes to adopt either C or S shape.

Scoliosis affects about twice as many girls as boys, and is most likely to develop any time from early childhood through to adolescence.

Symptoms

Other than the curvature of the spine – and sometimes a difference in the apparent height of the shoulders or the hips – there are often no symptoms, though there may be some back pain. In severe cases, the curvature of the spine may affect the movement of the ribs and even the heart, causing shortness of breath and chest pain.

What Causes Scoliosis?

In about 80% pf cases, the cause of scoliosis is unknown, though the condition often runs in families. However, an apparent scoliosis can also result from muscular imbalances caused by poor posture, a discrepancy in leg length or overdevelopment of the muscles on one side of the spine, as is seen in some professional tennis players. Another type of scoliosis – generally referred to as functional scoliosis – can develop as a response to a painful stimulus, such as herniated disc. Or sometimes a severe form of the problem results from a defect in a way that the spinal bones develop in the womb (congenital scoliosis).

Osteoarthritis and osteoporosis can also cause scoliosis if the damage they cause mostly affects one side of the spine.

Prevention

Scoliosis can generally be prevented only when it is caused by muscular imbalances that are created, and then worsened, by poor posture. In those instances, paying attention to your posture can help stave off the problem. Physiotherapy may help in this situation.

Figuring Out What’s Wrong

X-ray of the spine will be helpful to see the severity of the scoliosis.

Fixing The Problem

Functional scoliosis is treated by addressing the problem causing the muscular imbalance, often by means of physiotherapy. When scoliosis is idiopathic in a young person, a brace may be fitted to stop the curvature from becoming worse as growth continues. Surgery is generally advised for a young person if there are additional symptoms such as pain, breathing difficulty, or heart problems. Depending on the cause, this may involve the realignment of vertebrae followed by spinal fusion to fix them in place, or the removal of osteophytes – bony outgrowths from the vertebrae – formed as a result of osteoarthritis.

Lordosis

Lordosis

The left hand side of the picture shows a natural inward curve of the vertebral column in the lower back. In some people this becomes exaggerated, and in these cases the condition is known as lordosis.

Lordosis can cause pain and limit movement. It also reduces the spine’s efficiency as a shock absorber. As a result, even minor injury can cause damage to muscles, ligament, and vertebrae.

What Causes Lordosis?

Although lordosis tends to run in families, and in some cases can be present at birth as a result of developmental problems in the womb, most cases are caused by bad posture. The problem can also arise in later life as a result of a number of other conditions that cause degeneration of the spinal column, such as osteoarthritis and osteoporosis. Injury to the neck and back can also be a contributory factor.

What Are The Symptoms?

Apart from an unnatural and ungainly posture, neither cervical nor lumbar lordosis usually cause any symptoms, other than mild limitation in movement and sometimes mild discomfort. On rare occasions, severe lordosis may cause pressure on nerves as they leave the spinal cord, causing problems at the nerve’s root.

Prevention

The most important preventive measure you can take is to be vigilant about maintaining good postures at all times, and to be ready to make necessary adjustments throughout the day.

Figuring Out What’s Wrong

Lordosis is diagnosed by observation and confirmed by X-rays. The doctor will also check on the range of movement of your spine to see if it has become limited in any way.

Fixing The Problem

Often mild lordosis does not require specific treatment. But if the condition is causing pain, you may be advised to take medication or injection. A physical therapy program may be suggested, with the aim of improving your range of movement.

The emphasis of treatment is on correcting your posture and maintaining the improvement by constant vigilance.

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Dr Mathew Tung Neurosurgeon

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What is Decompressive Laminectomy for Lumbar Spinal Stenosis?

Decompressive laminectomy is the most common type of back surgery done to treat low back – spinal stenosisLaminectomy is done to relieve pressure on the spinal nerve roots caused by degenerative changes in the spine. It is also done to treat other spine conditions such as, spine injuries, slipped disc, herniated disc or tumours. The aim of the surgery is to reduce the pressure to the nerve roots so as to relieve your pain and allow you to return to your normal daily activities.

Laminectomy removes parts of the bone or thickened tissue that is narrowing the spinal canal or pressing the spinal nerve roots. Laminectomy involves a small incision to the back.

What To Expect After Decompressive Laminectomy

Recovery of the surgery is gradual.

Why Decompressive Laminectomy Is Done

Decompressive laminectomy for lumbar spinal stenosis is considered when:

  • Severe back pain symptoms has affect your day to day activities.
  • Tried all conservative (nonsurgical) treatments but the symptoms persist. Numbness and weakness to the legs gets worse and not getting better.
  • You cannot walk very well.
  • Bladder and bowel control may be affected.

How Well Decompressive Laminectomy Works

The surgery has good results and you will see the result the next day of the operation. The symptoms will be reduced significantly.

What To Think About for Decompressive Laminectomy

You may want to exhaust all nonsurgical treatments before choosing surgery.

One can try the below conservative treatments before proceeding to the surgery.

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