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Secondary effects : Osteophytes encroach upon the inter vertebral foramina, reducing the space for transmission of cervical nerves. If the restricted space in a foramen reduces still further by traumatic oedema of the contained soft tissues, manifestations of nerve pressure are likely to occur. Exceptionally, the spinal cord itself may suffer damage from encroachment of osteophytes within the spinal canal.

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Clinical Features : The symptoms are in the neck or in the upper limb, or both.

Neck symptoms consist chiefly of aching pain in the back of neck or in the trapezius area,
- a feeling of stiffness and
- grating on movement.

There us a Liability to periodic exacerbation’s, probably from unremembered stains or repetitive movements.
Occipital headache may be a feature it the upper half of the cervical spine is affected.

In the upper limb there may be an ill-defined and ill-localized “referred” pain spreading over the shoulder region, or there may be more serious symptoms from interference with one or more cervical nerves in their foramina. The main features of nerve root irritation is radiating pain along the course of the affected nerves, often reaching the digits.

There may also be a parenthesize in the hand, in the form of tingling or ‘pins and needles’. Noticeable muscle weakness is uncommon.
The cervical cord itself may be compressed by a central disc protrusion or from osteophytes arising from the posterior aspects of the vertebral bodies, giving rise to long tact signs and disturbances of gait.

Vertebral artery involvement by osteophytic growth may cause drop attacks, precipitated by extension of the neck. Osteophytes arising from the anterior vertebral margins may sometimes by their size give rise to dysphasia.

On Examination :
-the neck may show slight kyphosis.
-The posterior cervical muscles may be somewhat tender but they are not in spasm.
— Movements are not limited or restricted markedly except during acute exacerbations or when the degenerative changes are very advanced.
— Audible crepitation on movement is common — In the upper limb objective findings are usually slight or absent, for nerve pressure is seldom great enough to produce well-defined objective neurological signs and so demonstrable muscle weakness or sensory impairment is exceptional. Depression of one or more of the tendon reflexes is, however, fairly common.


Osteoarthritis of cervical spine. Note in the lateral view (left) the narrowed intervertebral space, with marginal osteophyte formation, at C.5—6 and at C.6—7. The oblique view (right) shows severe encroachment of osteophytes upon an intervertebral foramen.

Radiographic examination.

There is narrowing of the intervertebral disc space, with formation of osteophytes at the vertebral margins, especially anteriorly. Encroachment of osteophytes upon an intervertebral foramen is best demonstrated in oblique projections.

Complications :

If the spinal canal is markedly narrowed by osteophytes the spinal cord may be damaged, with progressive upper motor neurone disturbance affecting all four limbs and possibly the bladder. This complication is serious but uncommon. 


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