Neck (Cervical)
Cervical Spondylosis
경추 척추증
Chronic neck pain caused by degenerative changes of the cervical spine
- How common
- Very common (90% of those over 60)
- Typical age
- 50s and older
What is it?
Age-related degenerative changes occur in the cervical discs, joints, and ligaments, leading to chronic pain and functional decline.
Commonly affected: C5-6 and C6-7 levels are most commonly affected
How it develops
- Disc dehydrationWith aging, disc hydration decreases and disc height is reduced.
- Osteophyte formationBone spurs (osteophytes) develop along the vertebral body margins.
- Facet joint arthritisArthritis develops in the facet joints of the spine.
- Ligament hypertrophyThe ligamentum flavum thickens and may narrow the spinal canal.
Symptoms
- Chronic neck painNeck pain persisting for months to years with morning stiffness
- Restricted neck motionDifficulty turning or tilting the head
- HeadacheOccipital headache, often with tension-type headache
- Shoulder stiffnessTightness and stiffness around the trapezius
- CrepitusClicking sounds with neck movement (crepitus)
How it is examined
- Decreased cervical ROMReduced flexion, extension, rotation, and lateral bending
- Facet joint tendernessTenderness paramedian to the cervical spinous processes
- No neurological deficit (uncomplicated spondylosis)Radicular pain or muscle weakness may be absent
Imaging
Plain X-ray readily demonstrates degenerative changes.
- Osteophyte formation
- Disc space narrowing
- Loss of cervical lordosis
- Facet joint hypertrophy
MRI evaluates disc degeneration and nerve compression.
- Multilevel decreased disc signal (darkening)
- Neural foraminal narrowing due to osteophytes
- Ligamentum flavum hypertrophy
Non-surgical care
- Lifestyle modificationProper posture, reduced smartphone use, adjusted pillow height
- Exercise therapyCervical stretching and deep cervical flexor strengthening
- Anti-inflammatory analgesicsShort-term NSAIDs for flare-ups
- Physical therapyPain management with hot packs, ultrasound, and electrotherapy
Conservative options are generally tried first. Medications listed here can have side effects — discuss them with your prescriber.
When surgery is considered
Considered only when severe nerve compression is present
Procedures that may be discussed
- Osteophyte resection
- Cervical decompression and fusion
Outlook
A chronic condition where management outweighs cure. Exercise and posture correction can improve quality of life.