Uncinate spurring refers to a condition involving bony growths (osteophytes or bone spurs) on the uncinate processes of the cervical spine. These spurs develop over time and can affect surrounding neck structures. This article explains uncinate spurring, its formation, common signs, diagnostic methods, and treatment options.
Understanding Uncinate Processes
The uncinate processes are hook-shaped bony projections found on the lateral and posterior edges of the upper surfaces of the vertebral bodies in the cervical spine, from C3 to C7. These processes form joints with the vertebra above them, creating the uncovertebral joints, also called the joints of Luschka. These joints guide cervical spine motion, prevent excessive side-to-side translation, protecting the spinal cord and nerve roots from disc herniation.
A spur is an abnormal bony outgrowth on these uncinate processes. Osteophytes represent the body’s attempt to stabilize areas with degenerative changes. While uncinate processes are normal anatomical features, spur formation indicates a pathological process.
Formation of Uncinate Spurring
Uncinate spurring arises from degenerative changes in the cervical spine, often linked to aging. Over time, intervertebral discs, which cushion vertebrae, can lose hydration and height, reducing spacing between bones. Disc degeneration increases stress and instability in the uncovertebral joints.
Increased mechanical stress and micro-trauma prompt the body to stabilize the affected spinal segment by forming new bone. This process develops osteophytes (bone spurs) on the uncinate processes. These spurs are extra bone growth extending into areas with nerves and the spinal cord. Spur formation is a hallmark of cervical spondylosis, a common age-related neck condition.
Recognizing the Signs
Symptoms often emerge when uncinate spurs compress nearby nerves or the spinal cord. Common symptoms include neck pain, which can be localized or spread to the shoulders and upper back. Stiffness, especially after inactivity, is common.
When spurs impinge on a nerve root, individuals may experience radiculopathy, characterized by pain radiating into one or both arms, hands, or fingers. This pain can be accompanied by numbness, tingling, or a “pins and needles” sensation in the affected limb. Severe spinal cord compression, known as cervical myelopathy, can lead to widespread neurological deficits. Myelopathy symptoms include weakness in the arms or legs, difficulty with fine motor skills, balance problems, and gait disturbances.
How It’s Diagnosed
Diagnosis typically begins with a medical history and physical examination. During the physical exam, a provider assesses neck range of motion, palpates for tenderness, and performs neurological tests to evaluate muscle strength, reflexes, and sensation in the arms and legs. These assessments help determine nerve compression and its location.
Imaging confirms uncinate spurs and evaluates their impact on surrounding structures. X-rays are often the initial imaging, clearly showing bony changes and osteophytes. For a detailed view of the spinal canal, nerve roots, and spinal cord, a Computed Tomography (CT) scan may be performed. Magnetic Resonance Imaging (MRI) is useful for visualizing soft tissues like intervertebral discs, ligaments, and the spinal cord, helping identify compression or inflammation.
Treatment Options
Treatment often begins with conservative approaches to manage symptoms and improve neck function. Physical therapy is a common initial step, focusing on strengthening neck muscles, improving posture, and increasing flexibility. Non-steroidal anti-inflammatory drugs (NSAIDs) can reduce pain and inflammation. Muscle relaxants may also alleviate muscle spasms.
If conservative measures are insufficient, non-surgical interventions might be considered. Epidural steroid injections, administered around the spinal cord, can provide temporary relief by reducing inflammation and pain. For individuals with persistent, severe symptoms significantly impacting quality of life, or evidence of progressive neurological deficits due to spinal cord or nerve root compression, surgery may be an option. Surgical procedures decompress affected nerves or the spinal cord by removing bone spurs or other impinging structures, sometimes stabilizing the spinal segment.