Degenerative cervical spondylosis

A chronic, progressive deterioration of osteocartilaginous aspects of the cervical spine that is most often related to aging.

Cervical radiculopathy estimated annual incidence is approximately 83 cases per 100,000 persons in myelopathy for per hundred thousand as a result of cervical spondylosis.

Cervical spondylosis is more common in men than in women, with the peak incidence between ages 40-60 years for both men and women.

X-ray evidence of degeneration of the cervical spine occurs in essentially all people as they age, but not all patients have the typical symptoms of neck pain or neurologic deficits that correspond to the mechanical compression of neural elements.
Symptomatic cervical spondylosis is managed with nonsurgical treatment options with the result of abatement of symptoms.
Surgical intervention is indicated there is clinically significant neurologic dysfunction or progressive instability or deformity of the cervical spine.
There is no proof therapy addresses the cause of degenerative cervical spondylosis or reverses deterioration.
In selected patients, surgical intervention can improve outcomes.
Refers to age related wear and tear affecting elements of the cervical spine overtime including: intervertebral disks, facet joints, and other connective tissue structures, such as cervical spinal ligaments.
While degenerative cervical spondylosis affects any component of the cervical spine such as bone quality and joint structures, the most clinically significant changes occur in the intravertebral disks and facet joints.
The intravertebral disc consists of the anulus fibrosus on the exterior border of the disk and the nucleus proposes in the interior.
The intravertebral disks are metabolically active tissues, and cells within the disk, where oxygen is scarce have mechanisms to compensate for the relative hypoxia, including the upper regulation of hypoxia-inducible factors (HIF).
Degeneration of the cervical spine may also have an immune inflammatory component.
Degenerative cervical spondylosis may be associated with neck pain, mechanical or axial neck pain, compression, and inflammation of the cervical nerve roots exit in the cervical spine, that is cervical radiculopathy, and compression inflammation of adjacent cervical spinal cord.
Degenerative changes of the spine may begin as early as the first decade of life.
Approximately 80-90% of people have disc generation on MRI imaging by the age of 50 years.

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