JAWAHAR

NAVODAYA
VIDYALAYA
KAGAL
KOLHAPUR.
 CERVICAL
SPONDYLOSIS
BIOLOGY INVESTIGATORY PROJECT
Made by:

SUJAY NIRMALE
XI sci.

SUBJECT TEACHER-
Mr.,G.R.Chopde

CERTIFICATE
 This is to certify that SUJAY NIRMALE , of
class XI sci. has successfully completed the
investigatory project on Cervical
Spondyolsis under the guidance of Mr.
G.R.Chopde [Biology teacher] during the
year 2016-17.

Signature of external examiner Sign of biology teacher

Signature of Principal

ACKNOWLEDGEMENT
At the very outset I am very much grateful to our
beloved and respected teacher Mr.G.R.CHOPDE for
his kind support and guidance that he has been
providing during the preparation of this project.
I also express my sincere thanks to my parents
who helped me in all aspects in completing this
project.

SUJAY NIRMALE

Student of class XI sci.

INDEX
1. Certificate
2. Acknowledgement
3. Introduction
4. Cervical spondylosis
5. Causes and Risk factors
6. Symptoms
7. X-rays showing cervical spondylosis
8. Exams and tests
9. Treatments
10. Case study
11. Bibliography

INTRODUCTION
Cervical spondylosis is usually an age-related condition
that affects the joints in your neck. It develops as a result
of the wear and tear of the cartilage and bones of the
cervical spine. While it is largely due to age, it can be
caused by other factors as well. Alternative names for it
include cervical osteoarthritis and neck arthritis.

According to the studies, the condition is present in more

than 90 percent of people over the age of 65, although
some have it in such small degrees that they never
experience symptoms.
For some, it can cause chronic pain, although many
people who have it are still able to conduct normal, daily
activities.

CERVICAL SPONDYLOSIS
Spondylosis is a term referring to
degenerative osteoarthritis of the joints between
the center of the spinal vertebrae and/or neural
foramina. If severe, it may cause pressure on
nerve withsubsequent sensory and/or motor distur
bances such as pain, parenthesis, or muscle
weakness in the limbs.
Spondylosis is from Ancient Greek spondylos, "a
vertebra", in plural "vertebrae - the backbone".
When the space between two adjacent vertebrae
narrows, compression of a nerve root emerging from
the spinal cord may result in radiculopathy (sensory and
motor disturbances, such as severe pain in the neck,
shoulder, arm, back, and/or leg, accompanied by muscle
weakness). Less commonly, direct pressure on the spinal
cord (typically in the cervical spine) may result
in myelopathy, characterized by global weakness, gait
dysfunction, loss of balance, and loss of bowel and/or
bladder control. The patient may experience a
phenomenon of shocks (parenthesis) in hands and legs
because of nerve compression and lack of blood flow. If
vertebrae of the neck are involved it is
labeled cervical spondylosis. Lower back spondylosis is
labeled lumbar spondylosis.

Cervical Spondylosis
Causes and Risk Factors
Aging
Cervical spondylosis often develops as a result of changes in
your neck joints as you age. Your spinal disks can become dry
and begin shrinking around the time you turn 40, reducing the
cushioning between the bones in your neck.

Your disks might also develop cracks as you get older. This
causes them to bulge or become herniated. You might also
 develop bone spurs, or extra bony growths. Herniated disks and
bone spurs can put extra pressure on your spinal cord and nerve
roots, causing joint pain.

The ligaments in your spine, which are strands of tissue that

connect your bones, might also become stiffer as you age. This
makes it more difficult or painful for you to move your neck.

Other Factors
Cervical spondylosis can develop due to factors other
than aging. These include:

Neck injuries.
Work-related activities that put extra strain on your neck
from heavy lifting.
 Holding your neck in an uncomfortable position for
prolonged periods of time, or repeating the same neck
movements throughout the day (repetitive stress).
genetic factors (family history of cervical spondylosis)
Smoking.
Being overweight and inactive.

Symptoms
Most people with cervical spondylosis dont have
noticeable symptoms. If symptoms do occur, they can
range from mild to severe and may develop gradually or
occur suddenly.

One common symptom is pain around the

shoulder blade. Patients will complain of
pain along the arm and in the fingers.
 The pain might increase on standing sitting, sneezing,
coughing, or backward tilting of the neck.

Another common symptom is muscle weakness. Muscle

weakness makes it hard to lift the arms or hold objects
firmly.

Symptoms often develop slowly over time. But they may

start or get worse suddenly. The pain may be mild, or it
can be deep and so severe that you are unable to move.

You may feel the pain over the shoulder blade. Or it may
spread to the upper arm, forearm, or fingers (in rare
cases).

The pain may get worse:

After standing or sitting

At night
When you sneeze, cough, or laugh
When you bend the neck backwards or walk more than a
few yards
 Other common symptoms
Neck stiffness that gets worse over time
Numbness or abnormal sensations in the shoulders, arms,
or legs (in rare cases)
Headaches, especially in the back of the head

Less common symptoms

Loss of balance
Loss of control over the bladder or bowels (if there is
pressure on the spinal cord)
X-RAYS SHOWING
CERVICAL SPONDYLITIS
 Exams and Tests
A physical exam may show that you have trouble
moving your head toward your shoulder and
rotating your head.

Your health care provider may ask you to bend your head
forward and to each side while putting slight downward
pressure on the top of your head. Increased pain or
numbness during this test is usually a sign that there is
pressure on a nerve in your spine.

Weakness or loss of feeling can be signs of damage to

certain nerve roots or to the spinal cord.

A spine or neck x-ray may be done to look for arthritis or

other changes in your spine.
MRI of the neck is done when you have:
Severe neck or arm pain that does not get better with
treatment
Weakness or numbness in your arms or hands
EMG and nerve conduction velocity test may be done to
examine nerve root function.
TREATEMENTS
Treatment for cervical spondylosis aims to
relieve symptoms of pain and prevent permanent
damage to your nerves.

Pain relief
Over-the-counter painkillers
Non-steroidal anti-inflammatory drugs (NSAIDs) are
thought to be the most effective painkillers for symptoms
of cervical spondylosis. Some commonly used NSAIDs
include:
diclofenac
ibuprofen
naproxen
If one NSAID fails to help with pain, you should try an
alternative.
However, NSAIDs may not be suitable if you
have asthma, high blood pressure, liver disease, heart
disease or a history of stomach ulcers. In these
circumstances, paracetamol is usually more suitable.
Muscle relaxants
If you experience spasms, when your neck muscles
suddenly tighten uncontrollably, your GP may prescribe a
short course of a muscle relaxant such as diazepam.
Muscle relaxants are sedatives that can make you feel
dizzy and drowsy.Muscle relaxants should not be taken
continuously for longer than a week to 10 days at a time.

Amitriptyline
If pain persists for more than a month and has not
responded to the above painkillers, your GP may
prescribe a medicine called amitriptyline.
Amitriptyline was originally designed to treat depression,
but doctors have found that a small dose is also useful in
treating nerve pain. Some side effects when taking
amitriptyline, include:
drowsiness
dry mouth
blurred vision
constipation
difficulty urinating
Injection of a painkiller
If your radiating arm pain is particularly severe and not
settling, there may be an option of a "transforaminal
nerve root injection", where steroid medication is
injected into the neck where the nerves exit the spine.
This may temporarily decrease inflammation of the nerve
root and reduce pain.
Side effects include headache, temporary numbness in
the area and, in rare cases, spinal cord injury (limb
paralysis).

Exercise and lifestyle changes

You could consider:
Doing low-impact aerobic exercises such
as swimming or walking read more
about easy exercises.
Using one firm pillow at night to reduce
strain on your neck.
Correcting your posture when standing and sitting
read more about how to sit correctly.
The long-term use of a neck brace or collar is not
recommended, as it can make your symptoms worse. Do
not wear a brace for more than a week, unless your GP
specifically advises you to.

Surgery
Surgery is usually only recommended in the treatment of
cervical spondylosis if:
there is clear evidence that a nerve is being pinched
by a slipped disk or bone (cervical radiculopathy), or
your spinal cord is being compressed (cervical
myelopathy)
There is underlying damage to your nervous system
that is likely to worsen if surgery is not performed.
The type of surgery used will depend on the underlying
cause of your pain or nerve damage. Surgical techniques
that may be used include:

Anterior cervical discectomy This is used when a

slipped disc or osteophyte (lump of extra bone) is
 pressing on a nerve. The surgeon will make an
incision in the front of your neck and remove the
problem disc or piece of bone. This procedure
results in a fusion across the disc joint.
Cervical laminectomy The surgeon will make a
small incision in the back of your neck and
remove pieces of bone that are pressing on your
spinal cord. A similar approach is known as
a laminoplasty, where bones are spread open to
widen the space, but not removed.

Prosthetic intervertebral disc replacement This

relatively new surgical technique involves removing
a worn disc in the spine and replacing it with an
artificial disc. The results of this technique have
been promising, but as it is still new, there is no
evidence about how well it works in the long term,
or whether there will be any complications.

Most people can leave hospital within three to four days,

but it can take up to eight weeks before you can resume
normal activities. This may have an impact on your
employment, depending on the type of work you do.
Many people are recommended to return to work on a
part-time basis at first, although you should discuss this
with your employer before surgery.
Complications of surgery
Like all surgical procedures, surgery on the cervical spine
carries some risk of complications, including:
Rare complications associated with general
anesthetic such as heart attack, blood clot in the
lung (pulmonary embolism) or a severe allergic
reaction (anaphylaxis).
Some mild difficulties with swallowing (dysphasia)
this usually passes within a few months.
Hoarse voice this is a rare complication, but when
it does occur it can be permanent.
Paralysis (inability to move one or
more parts of the body) which
could occur if there is bleeding
into the spinal canal after surgery,
or the blood supply to spinal nerves
is damaged.
Infection of the wound after surgery which is not
usually serious and can be treated with antibiotics
(deeper spinal infection is more serious but very
rare).

CASE STUDY 1
Date: 07-09-2016

Name of patient: Mr. Ajay Patil

Age: 48
Sex: Male
Name of doctor/hospital:Mahavir Patil,Hridya
hospital
Symptoms/Problems: 10 years of history of chronic neck pain,
headache, and episodic vertigo and tinnitus
Diagnosis: a large central herniation of C5/6 disc
Treatment: ACDF at the C5/6 disc level
After surgery, strength in all 4 limbs was significantly recovered, and
symptoms of neck pain, headache, vertigo, and tinnitus disappeared.
Precautions advised: undergone a follow-up of 12 months
(Test report can be attached): X-ray attached with
the report
CASE STUDY 2

Date: 13-09-2016

Name of patient: Mrs. Meera Khopade

Age: 38
Sex: Female
Name of doctor/hospital: Dr. Mamta Sharma (physiotherapist)
Symptoms/Problems: A three month history of neck and right
shoulder pain
Worse when she first wakes up and at the end the day
Difficulty in looking over shoulder
Diagnosis: cervical degeneration of the discs C3-C6 with mild osteophyte
formation
Treatment: Hi- TENs (no contraindications) applied for 10 mins. to C5 nerve
root
Home exercises program (HEP): Cervical retractions, Gentle rotation with
over pressure
Advised to do heat and ice techniques at home.
Precautions advised: to discontinue exercise if produces pins and
needles, numbness or dizziness
(Test report can be attached): X-ray attached with
the report
CONCLUSION
From the reports above it is clear that though cervical
spondylosis is of many types, radiculopathy is the most
commonly found. Radiculopathy includes sensory and
motor disturbances, such as severe pain in the neck,
shoulder, arm, back, and/or leg, accompanied by muscle
weakness.

In case 1, the patient is suffering from a longer time and

hence, he had to undergo surgery for relief. He had to
undergo a follow-up for 12 months after the surgery.

In case 2, since the condition was detected in a very

early stage therefore, the patient recovered doing a
regular session of exercises as diagnosed by a
physiotherapist. The treatment involved following of
daily routine exercises strictly. Treatment was
considered effective because all goals were met.
Thus, it is clear that cervical spondylosis can be cured in
many different ways depending on the extent of harm
the patient has suffered. But sure enough, there are
numerous treatments to cure cervical spondylosis and
make all the sufferings vanish to let the sufferer enjoy a
normal life without any problems.

BIBLIOGRAPHY

www.google.com
www.wikipedia.com
www.medindia.net
www.emedicinehealth.com