Orthopedics: Conditions

Spondylolysis refers to a degenerative process affecting the vertebral disc and facet joints that gradually develops with age (arthritis). Most of the time, this condition causes mild to moderate neck pain and stiffness.

A common form of spondylolysis causing neck pain is cervical spondylolysis (cervical arthritis), in which the facet joints in the neck become enlarged, causing the ligaments around the spinal canal to thicken and bone spurs to form.

Many people have spondylolysis of the neck and do not know it. This is because most of the time, there are no symptoms, or the symptoms are mild. When symptoms develop, they are typically neck pain, stiffness, and sometimes scapular and shoulder pain. When the spondylolysis causes spinal nerve root or spinal cord compression, this is a more serious condition.

Most patients who do not have neurological compression associated with spondylolysis do not need surgery. Interventional treatments for cervical spondylolysis may include:

• Medications, such as non-steroidal anti-inflammatory drugs (NSAIDs) to reduce swelling and pain and analgesics to relieve pain
• Physical therapy and/or exercises for exercises to help relieve the pressure on the nerve root
• Facet joint injections and medial branch blocks to help reduce swelling and treat acute pain that radiates to the hips or down the leg
• Radiofrequency lesioning (RF)
• Physical therapy and/or exercises for exercises to help relieve the pressure on the nerve root

For spondylolysis without nerve root compression (radiculopathy) or spinal cord compression (myelopathy), surgery is typically avoided. In some unusual conditions, cervical spinal fusion can be performed.