Arthritis in the Spine

Causes of spinal spondylosis

Spondylosis most commonly occurs as a result of the day-to-day stress and strain over time on the body. As you age, your joints and spine structures are degenerating. Spondylosis affects the lumbar spine more frequently than it affects the cervical or thoracic spine.

Conditions associated with arthritis in the spine include:

• Herniated or bulging discs
• Spinal stenosis
• Bone spurs
• Spondylolisthesis
• Degenerative disc disease

Younger people can develop spinal osteoarthritis from:

• Genetic defects that involve the cartilage
• Injury to a joint in the spine

Risk factors for spinal spondylosis

• Age — as people age, they are at a higher risk for developing spinal osteoarthritis.
• Gender — women are more likely to develop spinal osteoarthritis.
• Occupation — some occupations that require heaving lifting and repetitive movement on the spine can increase your risk of developing spinal osteoarthritis.
• Genetics — some people can inherit spinal osteoarthritis from their family.
• Weight — the extra weight carried by obese patients can add extra pressure on the spine.

Symptoms of spinal spondylosis

Many people do not experience symptoms related to spondylosis. The most common symptoms of spinal osteoarthritis are pain and stiffness in the back or neck.

Symptoms of spinal osteoarthritis include:

• Muscle weakness in the lower back, legs or arms
• Difficult walking
• Lack of coordination
• Numbness or tingling in the extremities (legs, arms, hands or feet)
• Stiffness
• Muscle spasms

As the condition worsens, your symptoms may intensify. Patients with mild spinal spondylosis may only notice minor symptoms like hamstring tightness or inability to touch your toes.

Diagnosis of spinal spondylosis

Spinal osteoarthritis can be diagnosed in a full medical and physical exam with your primary care doctor. During the medical exam, your doctor will ask you what your symptoms are, when they occur and when they are at their worst. After the medical exam, your provider will take a physical exam of the body. He or she will perform tests that evaluate your pain, tenderness, loss of sensation or loss of motion in the lower back.

Your physician may also order the following diagnostic tests:

• X-ray — x-ray images can confirm the spinal osteoarthritis diagnosis and show bone damage, bone spurs or cartilage loss. 
• Blood tests — a blood test can exclude other diseases that have similar symptoms.
• MRI — an MRI can show damage to the discs or if there is narrowing in the area where the spinal nerves exit.

Treatments for spinal spondylosis

Most patients can experience symptom relief from nonsurgical treatment options such as medication, rest and physical therapy. Your doctor will monitor your progression, and if your symptoms are not improving or worsening, you may need surgical intervention.

• Medications — over-the-counter anti-inflammatory medications are a first-line therapy for mild spondylosis; if these medications are not effective, prescription medications or injections may be needed.
• Physical therapy — physical therapy, under the guidance of a certified physical therapist, can help strengthen the muscles around the spinal cord.

Patients who are experiencing any of the following symptoms/conditions as a result of arthritis may need spinal surgery:

• Bowel or bladder dysfunction
• Spinal stenosis
• Neurological dysfunctions
• Unstable spine

For most patients who require surgery, surgery occurs in two parts, removing what is causing the symptoms (decompression surgery), followed by spinal fusion (stabilization surgery).

Decompression surgeries to treat spondylosis can include:

Facetectomy
If the facet joints put pressure on your nerves, you may need surgery to remove the facet joint to relieve the pressure.

Foraminotomy
During a foraminotomy procedure, your surgeon will enlarge the opening where the nerve exits the vertebra. The goal of this procedure is to relieve pressure on the nerve so the nerve can exit without being compressed by a bone spur or disc.

Laminectomy
If the plate on the back of the vertebra that protects the spinal canal and cord is pressing on the spinal cord, it may need to be removed to relieve your symptoms.

Laminotomy
During a laminotomy procedure, your surgeon will relieve the pressure on the nerve structure by creating a larger opening in the lamina (the bony plate that protects the spinal canal and spinal cord).

Corpectomy
A corpectomy, also called a vertebrectomy, is a surgery that removes part of the vertebrae when bone spurs form between the vertebrae and spinal cord compressing the nerves.

After decompression surgery, your surgeon will perform stabilization surgery to fuse the spine together. Spinal fusion surgery is typically the procedure performed to stabilize the spine. Spinal fusion can be done from the back, from the front or from the side.

Recovery from spinalspondylosis

Recovery after surgery to correct spinal osteoarthritis can take as long as 12 weeks. Stiffness and some loss of motion is typical after this type of surgery. Physical therapy can help strength the muscles around the affected area.