My Spine - Cervical
At the same time the facet joints at the back of the neck can undergo
osteoarthritic changes. The combination of loss of height and facet joint
arthritis lead to an imbalance of the neck. At the same time the arthritic
changes in the joints and abnormal alignment of the spine causes local nerve
and muscle irritation which leads to muscle spasm and referred pain. The
combination of enlarged facet joints, disc herniation, osteophytes and spinal
ligament enlargement leads to narrowing of the spinal canal.
Cervical osteoarthritis and abnormal alignment is called cervical spondylosis.
When the spinal canal is narrowed and the spinal cord is being compressed,
it leads to dysfunction of the nerves of the spinal cord.
What are the symptoms?
Compression of nerve roots leaving the spinal canal causes pain in the arm(s),
sensory abnormalities (feeling of pins and needles) in the arm(s) and weak-
ness of the arm muscles supplied by those nerves. This is called a radiculopa-
thy. The dysfunction of the spinal cord as a result of compression is called
myelopathy. Myelopathy is a disease of the spinal cord that manifests as pain
and weakness in the arms and also spasticity of the arms. The early manifes-
tations can often be the inability to perform intricate tasks with the hands and
fingers and stumbling when walking. It can also cause dysfunction of the
nerves to the bladder and the bowel.
How is it diagnosed?
A clinical examination by your specialist or therapist will allow for a reason-
able suspicion, but the only definite way is by doing a magnetic resonance
imaging (MRI) scan (see the chapter Tests and Scans).
Sometimes, because of technical factors, a CT scan is performed (see the
chapter Tests and Scans). This is usually when an MRI scan cannot be per-
formed due to the unavailability of an MRI scanner, when there are contra-
indications to doing an MRI scan or when technical factors such as the pres-
ence of certain metal fusion apparatus in the spine, make an MRI scan unre-
liable.
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