Spondylosis: Degenerative Changes in the Spine and Spondylarthrosis (Spondylosis Deformans) | Information & Spondylosis Specialists

“Spondyl” comes from Greek and means “vertebra,” while the suffix “-osis” refers to degenerative changes. Spondylosis is therefore a general term for several degenerative diseases of the spine. Back pain is a very common symptom of spondylosis. 

A characteristic feature of spondylosis is additional bone growth at areas of the spine that are subject to particular stress. This results in bony protrusions on the vertebral bodies, also known as spondylophytes. Spondylosis therefore leads to deformities of the spine, which is why the medical term “spondylosis deformans” has become established. “Deformans” here means “deformed.”

Spondylosis can affect any section of the spine—that is, the cervical, thoracic, or lumbar spine. Due to the strain placed on humans who walk upright, the lumbar spine is most commonly affected.

The spine is subjected to significant stress over the course of a person’s life, primarily due to our upright posture. This places strain on the vertebral bodies, which bear the brunt of the load.

In addition, the intervertebral discs located between the vertebral bodies gradually lose flexibility and elasticity over time, becoming thinner and more brittle. Normally, the cartilaginous discs between the vertebral bodies serve to protect them, acting as a cushion, so to speak. Over time, however, this cushioning effect diminishes, and the stress on the vertebral bodies steadily increases. As a result, adjacent vertebrae can move closer together and even come into contact with one another. 

The so-called facet joints of the spine are the first to be affected. This leads to facet syndrome. You can see how this degenerative condition develops in the video:

This wear and tear causes the spine to lose stability. Additional bone growth is intended to reinforce and stabilize the spine again. As a result, the body forms the spondylophytes mentioned above, which are the cause of back pain.

In some cases, these spondylophytes may also press on

• nerves
• blood vessels, and 
• the spinal canal

. This results in additional pain and neurological symptoms.

In some cases, the spondylophytes that grow on different vertebrae fuse together. This creates a continuous bony structure that further restricts the mobility of the spine. 

In addition to stress reactions caused by walking upright, metabolic disorders can also be a cause of spondylosis. For example, diabetes is a possible cause of what is known as spondylosis hyperostotica. 

Depending on which areas of the spine are affected by spondylosis, symptoms vary in severity. Initially, wear and tear on the spine typically manifests only as mild symptoms and pain. More severe symptoms develop gradually.

Back pain is common in spondylosis. The pain may also occur in the neck or radiate into the arms and legs.

Spondylosis, or spinal degeneration, can partially affect the spinal cord and peripheral nerves if compression occurs in these areas. If the spinal nerves or the spinal cord are damaged, additional neurological deficits typically occur:

• Sensory disturbances, such as tingling in the arm
• Loss of bladder and bowel control (bladder or bowel incontinence)
• Numbness
• unexpected weakness that cannot be explained by muscle weakness
• Movement disorders, such as gait disturbances, and paralysis

In addition to the typical symptoms of back pain and the compensatory posture that is already visible externally, further examinations are generally necessary to diagnose spondylosis. These include, among others:

• an X-ray
• a computed tomography (CT) scan or
• a magnetic resonance imaging (MRI) scan

These tests can visualize the condition of the spine and spinal cord and, among other things, rule out other degenerative changes and diseases. An X-ray is the simplest test; CT and MRI are more accurate and are often indicated in cases of pronounced findings or for specialized treatments.

In some cases, additional tests may be necessary, for example, to check for and confirm possible nerve deficits. If inflammation is suspected, a blood test is usually required as well.

In many cases, physical therapy is sufficient to alleviate symptoms and help the patient return to a nearly pain-free daily life. Exercises to strengthen the back muscles can also be helpful in treating instability in the back. Sometimes, at least temporarily, it becomes necessary to take pain medication or to inject a local anesthetic into the affected sections of the spine.

If the pain is caused by facet syndrome, injections have proven to be an effective form of pain management. The video demonstrates how a facet injection is performed:

Surgery for spondylosis may be necessary, especially when the spinal cord is compressed and thereby damaged. In such cases, the spinal cord must be relieved of pressure immediately to prevent permanent damage. This involves removing the spondylophytes that are causing the problem and constricting the spinal cord, and widening the spinal canal.

In some cases, it may also be necessary to remove the entire vertebral body, which must then be reconstructed using an artificial implant. This is the only way to relieve pressure on the spinal cord and stabilize the spine. Sometimes, it may be sufficient to simply correct the position of the vertebra.

The videos provide information about the surgical options:

As a general rule, the surgery involves correcting and replacing as much of the body’s own tissue as necessary, but as little as possible, in order to keep the procedure as short as possible and minimize surgical risk.

Sometimes spondylosis is also caused by diabetes or another metabolic disorder. In such cases, treating the underlying condition plays an important role.

Many adults show early signs of wear and tear in the spine and intervertebral discs. These signs progress with age.

The overwhelming majority of people over the age of 65 have bone spurs on their vertebrae. Spondylosis often goes undiagnosed and is asymptomatic; only a portion of those affected suffer from symptoms such as

• back pain 
• limited mobility, or
• sensory disturbances

Spondylosis can sometimes lead to further complications. Spondylosis accompanied by radiculopathy or myelopathy causes patients to experience neurological symptoms and nerve pain. As the disease progresses, muscle tension may also develop, which can cause pain.

This muscle tension often results from a compensatory posture that those affected adopt due to spondylosis.

The best time to take preventive measures is before you develop spondylosis. Typical signs of aging, such as the deterioration of the intervertebral discs, cannot be completely prevented. Nevertheless, there are steps you can take to support your back health.

Here’s how you can reduce your risk of spondylosis:

• Strengthen your muscles through targeted strength training
• Maintain good posture—whether sitting, standing, or carrying heavy objects.
• An ergonomically designed desk also helps maintain back health for longer.
• Maintaining a healthy body weight takes pressure off the spine and joints.

If your back pain does not improve within three to six weeks, consult a doctor.

In many cases, a physical therapist helps patients improve their back health. However, not every sport is suitable for strengthening the back muscles in cases of spondylosis. Jerky movements, for example, are generally considered problematic for people with back issues.