Lumbar Spondylosis (Arthritis)

Spondylosis is a condition where the bones that make up the spine (vertebrae) degenerate. Typically this degeneration forms bony projections (bone spurs) and reduces the height of the spongy discs between the vertebrae.

Spondylosis is often called spinal osteoarthritis. It can affect the neck (cervical spine), upper, mid and lower back (thoracic spine and lumbar spine). The most common area affected is that of the lumbar spine and cervical spine.

Causes

The causes of spondylosis are:

  • Age, which leads to wear and tear of spinal ligaments and bones
  • Weakened and degenerated intervertebral discs
  • Genetic predisposition

Signs and Symptoms

The signs and symptoms of spondylosis include:

  • Back and neck pain
  • Numbness and tingling of arms and legs if nerve compression also exists
  • Muscle spasms
  • Sciatica (low back pain extending down the leg)

Frequently, you may have spondylosis, but not show any symptoms.

Diagnosis

Your doctor will diagnose spondylosis after reviewing your medical history and performing a physical examination.

Additional diagnostic tests for spondylosis may be ordered, including Radiology tests such as:

  • X-rays
  • Magnetic resonance imaging (MRI)
  • Computerized tomography (CT) scans
  • Myelogram
  • Electromyogram and nerve conduction studies to measure electrical activity of the nerves

Treatment

Treatment of spondylosis depends on the type and severity of symptoms.

Conservative therapy may include :

  • Medications : Your doctor may prescribe anti-inflammatory medications, and analgesics (pain medications), muscle relaxants, anti-depressants and topical applications for relieving your neck and back pain.
  • Self-care : You can use heat and/or ice therapy to lessen the pain. You can experiment with different types of pillows to help with neck pain. Everyone is different as to which type of pillow is best to help with symptoms.
  • Exercises : Your therapist will teach you exercises to strengthen your back and stomach muscles. Regular walking, yoga, and regular aerobic exercise will also help in relieving chronic back and neck pain.
  • Adjunctive therapies : Acupuncture, which involves the insertion of very thin needles into the body, may be beneficial for back pain.
  • Chiropractic spinal manipulations may also be suggested to improve your lower or mid back pain.
  • Your doctor may suggest minimally invasive procedures such as steroid injection and radiofrequency ablation.

Steroids may be injected into facet joints (joints between adjacent vertebrae), epidural space (space around the spinal cord), or intervertebral disc spaces, to reduce acute pain and pain radiating into a limb.

  • Your doctor may also perform radiofrequency denervation technique, in which the nerves causing pain are detected and treated, to stop the transfer of pain messages.

Surgery

Your doctor will suggest surgery if conservative treatment does not relieve pain from spondylosis. Surgery is not meant to treat back pain, but will only be offered if leg pain from nerve compression is a major component of the symptoms. Spinal decompression surgery is a general term used for various procedures that are performed to relieve pressure on your nerves caused by compression. These include the following procedures:

  • Laminectomy removes the bony arches over the spinal cord to decrease the pressure on the spinal nerves.
  • Discectomy removes part of the intervertebral disc that is applying pressure on the nerve.
  • Foraminotomy enlarges the openings from which nerve roots emerge.
  • Osteophyte removal removes bony projections such as bone spurs which cause pinched nerves.
  • Corpectomy removes a vertebral body and its disc

Your surgeon may combine spinal fusion with any of these surgical procedures in order to stabilize the spine.