Uncovertebral spurring involves the formation of small, bony growths, or osteophytes, on the uncovertebral joints in the neck. These spurs are a common age-related change resulting from spinal wear and tear. While frequently observed on imaging, uncovertebral spurring does not always cause symptoms, with many individuals experiencing no pain or discomfort.
Understanding Uncovertebral Joints and Spur Formation
Uncovertebral joints, also known as Luschka’s joints, are structures found only in the cervical spine. These small, paired joints are situated on each side of the intervertebral discs, between the C3 and C7 vertebrae. Their function involves guiding neck movements, such as flexion and extension, and limiting lateral bending, contributing to cervical spine stability.
The development of bone spurs in these joints is a gradual process linked to the body’s response to degeneration. As cartilage cushioning within the uncovertebral joints wears down due to aging and mechanical stress, the body attempts to repair and stabilize the joint. This repair mechanism leads to the growth of new bone tissue at the joint margins, forming osteophytes.
Recognizing the Symptoms
Many people with uncovertebral spurring experience no symptoms, and the condition may only be discovered incidentally during imaging. However, when these bone spurs enlarge, they can encroach upon nearby nerves or the spinal cord, leading to various symptoms. A common complaint is neck pain and stiffness, which can worsen with activity.
If the spurs press on spinal nerves, individuals might experience radiating pain, numbness, tingling, or weakness in the arms and hands, a condition known as radiculopathy. Less frequently, significant compression of the spinal cord (myelopathy) can occur, causing more widespread symptoms such as balance issues, difficulty walking, or problems with fine motor skills. In rare instances, large spurs forming on the front of the cervical spine can lead to difficulty swallowing (dysphagia).
Diagnosing Uncovertebral Spurring
Diagnosing uncovertebral spurring begins with a thorough medical history and physical examination. A healthcare professional assesses the patient’s neck range of motion, evaluates pain patterns, and checks for neurological deficits like weakness, numbness, or altered reflexes in the limbs. This initial assessment helps correlate reported symptoms with potential physical signs.
Imaging tests are then used to confirm the presence and extent of the bone spurs. X-rays are often the first step, as they can readily show bony changes and the presence of osteophytes. For a more detailed view of soft tissues, nerves, and the spinal cord, a magnetic resonance imaging (MRI) scan may be performed. A computed tomography (CT) scan can provide intricate bone detail, which helps in assessing the size and location of the spurs relative to surrounding structures.
Management and Treatment Options
Treatment for uncovertebral spurring focuses on managing symptoms and improving function, as the spurs themselves do not disappear. Initial management involves conservative approaches. Over-the-counter pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs), can help reduce pain and inflammation. Muscle relaxants may also be prescribed to alleviate muscle spasms.
Physical therapy plays a role, focusing on exercises to strengthen neck muscles, improve flexibility, and correct posture, which can reduce stress on the affected joints. Applying heat or cold packs can also provide temporary relief from pain and inflammation. If conservative measures are insufficient, steroid injections might be considered to deliver anti-inflammatory medication directly to the affected area.
Surgical intervention is reserved for cases where conservative treatments have not provided relief, or when there is evidence of severe neurological involvement, such as progressive weakness or spinal cord compression. The goal of surgery is to decompress the nerves or spinal cord by removing the bone spurs or creating more space. Surgical procedures can include anterior cervical discectomy and fusion (ACDF), laminectomy, or foraminotomy, depending on the specific location and extent of compression. Many individuals find sufficient relief with non-surgical methods, avoiding the need for surgery.