Degenerative Cervical Spondylosis

Degenerative Cervical Spondylosis

1. Degenerative Cervical Spondylosis Ade Wijaya , MD; July 2020

2. Chronic progressive degeneration of osseocartilaginous components of the cervical spine  aging Synonims : degenerative cervical spondylosis , cervical degenerative disease, cervical spondylosis , cervical osteoarthritis, and neck arthritis Introduction N Engl J Med 2020;383:159-68.

3. Berenbaum F. Osteoarthritis as an in-f lammatory disease (osteoarthritis is not osteoarthrosis !). Osteoarthritis Cartilage 2013; 21: 16-21.2. Haseeb A, Haqqi TM. Immunopatho -genesis of osteoarthritis. Clin Immunol 2013; 146: 185-96.

4. Epidemiology 80 to 90% of people have disk degeneration on magnetic resonance imaging (MRI) by the age of 50 years (not always symptomatic) A review of the global burden of low back and neck pain estimated that in 2015, more than a third of a billion people worldwide had mechanical neck pain of at least 3 months’ duration Cervical radiculopathy : 83 cases per 100,000 persons) Cervical myelopathy : approximately 4 per 100,000 Peak incidence between the ages of 40 and 60 years for both men and women N Engl J Med 2020;383:159-68.

5. Intervertebral disk  avascular Age-related changes such as vertebral bony end-plate calcification decrease the limited exchange of nutrient and waste products Such events may have a genetic basis or may be related to previous spinal trauma, including subclinical and unnoticed injuries Pathophysiology N Engl J Med 2020;383:159-68.

6. Up-regulation of proinflammatory cytokines Production of hydrophilic proteoglycans is decreased Disk desiccation Central nervous system may become sensitized and perpetuate neck discomfort in patients with chronic spinal pain Pathophysiology N Engl J Med 2020;383:159-68.

7. No neurological deficits: Analgesics Other conservative options , including physical therapy Epidural glucocorticoid C ervical traction Brief immobilization in a cervical orthosis Massage Psychology support Neurological deficits: surgical Treatment N Engl J Med 2020;383:159-68.

8. Staying physically active Maintaining good posture Preventing neck injuries Avoid smoking Manage obesity Prevention Kadow T, Sowa G, Vo N, Kang JD. Molecular basis of intervertebral disc degeneration and herniations : what are the important translational questions? Clin Orthop Relat Res 2015; 473: 1903- 12 .

9. Degenerative cervical spondylosis is caused by arthritic changes in the osseocartilaginous components of the cervical spine Neck pain, radiculopathy , myelopathy Treatment is generally nonsurgical, especially for pain and mild radiculopathy , which are typically self-limiting . However , surgery is generally indicated to treat myelopathy and may be indicated for persistent and severe nerve-root compression Summary

10. THANK YOU Adios