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relating to or associated with the neck
of or relating to the cervix of the uterus; "cervical cancer"

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(子宮などの)頚(けい)部の(にできた)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/08/16 16:56:36」(JST)

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Spondylosis is a term referring to degenerative osteoarthritis of the joints between the center of the spinal vertebrae and/or neural foramina. If this condition occurs in the zygapophysial joints, it can be considered facet syndrome. If severe, it may cause pressure on nerve roots with subsequent sensory and/or motor disturbances, such as pain, paresthesia, 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 (paresthesia) in hands and legs because of nerve compression and lack of blood flow. If vertebrae of the neck are involved it is labelled cervical spondylosis. Lower back spondylosis is labeled lumbar spondylosis.

Causes

Spondylosis can affect a person at any age; however, older people are more susceptible.^[1]

Diagnosis

Cervical Compression Test is performed by laterally flexing the patient's head and placing downward pressure on it. A positive sign is neck or shoulder pain on the ipsilateral side, that is, the side to which the head is laterally flexed. This is somewhat predictive of cervical spondylosis.
Lhermitte sign: feeling of electrical shock with neck flexion;
reduced range of motion of the neck, the most frequent objective finding on physical examination
MRI and CT scans are helpful for pain diagnosis but generally are not definitive and must be considered together with physical examinations and history.
Lumbar back pain can be the result of spondylosis, but most commonly is the result of muscle strain.

Treatment

Treatment is usually conservative in nature. Patient education on lifestyle modifications and nonsteroidal anti-inflammatory drugs (NSAIDs) and physical therapy have been shown to manage such conditions^{[citation needed]}. Other alternative therapies such as massage, chiropractic, trigger-point therapy, yoga and acupuncture may be of limited benefit^{[citation needed]}. Surgery is occasionally performed.

Many of the treatments for cervical spondylosis have not been subjected to rigorous, controlled trials.^{[citation needed]} Surgery is advocated for cervical radiculopathy in patients who have intractable pain, progressive symptoms, or weakness that fails to improve with conservative therapy. Surgical indications for cervical spondylosis with myelopathy (CSM) remain somewhat controversial, but "most clinicians recommend operative therapy over conservative therapy for moderate-to-severe myelopathy." (Baron, M.E.)

Physical therapy may be effective for restoring range of motion, flexibility, and core strengthening. Decompressive therapies (i.e. manual mobilization, mechanical traction) may also help alleviate pain. However, physical therapy and chiropractic cannot "cure" the degeneration, and some people view that strong compliance with postural modification is necessary to realize maximum benefit from decompression, adjustments, and flexibility rehabilitation.

It is often argued, however, that the cause of spondylosis is simply old age, and that posture modification treatment is often practiced by those who have a financial interest (such as Worker's Compensation)^[2] in proving that it is caused by work conditions and poor physical habits. Understanding anatomy is the key to conservative management of spondylosis.

Surgery

Many surgical procedures have been developed to alleviate the signs and symptoms associated with spondylosis. The vertebral column can be approached by the surgeon from the front, side, or rear. Osteophytes and sometimes portions of an intervertebral disc are commonly removed in an effort to relieve pressure on adjacent nerve roots and/or the spinal cord.

Complications

A major problem related to this disease is vertebrobasilar insufficiency. This is a result of the vertebral artery becoming occluded as it passes up in the transverse foramen. The spinal joints become stiff in cervical spondylosis. Thus the chondrocytes which maintain the disc become deprived of nutrition and die. The weakened disc bulges and grows out as a result of incoming osteophytes.

Laminectomy

References

^ Newman & Santiago, 2013^{[full citation needed]}
^ Diagnosis and Management of Cervical Spondylosis at eMedicine

External links

Cervical spondylosis at the Mayo Clinic

UpToDate Contents

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1. 頸部神経根障害の臨床的特徴および診断 clinical features and diagnosis of cervical radiculopathy
2. 頚椎症性脊髄症 cervical spondylotic myelopathy
3. 頚部痛および頚椎症の患者の評価 evaluation of the patient with neck pain and cervical spine disorders
4. 頸部神経根障害の治療 treatment of cervical radiculopathy
5. 頚椎性頭痛 cervicogenic headache

English Journal

Minimally Invasive Transforaminal Lumbar Interbody Fusion for Spondylolisthesis and Degenerative Spondylosis: 5-year Results.

Park Y, Ha JW, Lee YT, Sung NY.SourceDepartment of Orthopedic Surgery, National Health Insurance Service Ilsan Hospital, Yonsei University College of Medicine, 1232, Baeksok Street, Ilsan District, Goyang City, Gyeonggi Province, 410-719, Republic of Korea, yungspine@gmail.com.
Clinical orthopaedics and related research.Clin Orthop Relat Res.2013 Aug 18. [Epub ahead of print]
BACKGROUND: Multiple studies have reported favorable short-term results after treatment of spondylolisthesis and other degenerative lumbar diseases with minimally invasive transforaminal lumbar interbody fusion. However, to our knowledge, results at a minimum of 5 years have not been reported.QUESTI
PMID 23955260

Estimates of Annual Medical Costs of Work-related Low Back Pain in Japan.

Itoh H, Kitamura F, Yokoyama K.SourceDepartment of Epidemiology and Environmental Health, Juntendo University Faculty of Medicine, Japan.
Industrial health.Ind Health.2013 Aug 13. [Epub ahead of print]
Little is reported regarding economic burden of work-related low back pain except for the United States. In the present study, annual medical cost of work-related low back pain in Japan was calculated based on the treatment fee per day, a total of days of treatment received for low-back pain of all
PMID 23955653

[Occupation-related findings in patients with degenerative disc disease of the lumbar spine : Investigation of assessment relevant questions of the occupational disease number 2108 by descriptive representation of the data from the German spinal study.]

Linhardt O, Bolm-Audorff U, Bergmann A, Hering KG, Haerting J, Petereit-Haack G, Seidler A, Vaitl T, Grifka J.SourceOrthopädie und Unfallchirurgie, Orthopädiezentrum Arabellapark (OZA), München, Englschalkinger Str. 12, 81925, München, Deutschland, oliverlinhardt@aol.com.
Der Orthopade.Orthopade.2013 Aug 11. [Epub ahead of print]
BACKGROUND: A positive dose-response relationship between cumulative occupational lumbar load and lumbar disc herniation as well as lumbar disc narrowing among men and women was found in the EPILIFT study. The case subjects in the EPILIFT study concerning the occupational disease classification numb
PMID 23934043

Japanese Journal

潮熱を伴った痛みが桃核承気湯で軽減した1症例

米満亨,大納哲也,星野一,八木由紀子,上村裕一
The journal of the Japan Society of Pain Clinicians = 日本ペインクリニック学会誌 18(4), 377-379, 2011-09-25
頸椎症による根性痛の治療中に，残存した周期的な痛みが桃核承気湯を併用して軽減した症例を報告する．81歳の女性で，持続硬膜外ブロックにより速やかに左上肢の痛みが軽減したが，感染性腸炎を契機に周期的な体温の上昇に連動して痛みが増悪するようになった．体温の変化を陽明病期の潮熱と判断し，桃核承気湯を投与した．桃核承気湯を服薬翌日以後，体温は安定し，痛みは軽減した．
NAID 10029809609

椎体間ケージを使用した頚椎前方固定術

五十嵐秀俊,星野雅洋,大森圭太,松崎浩巳,根本泰寛,上井浩
東日本整形災害外科学会雑誌 = Journal of the Eastern Japan Association of Orthopaedics and Traumatology 23(2), 195-200, 2011-06-30
NAID 10029275732

Related Pictures

Cervical Spondylosis Images, Stock Photos & Vectors | Shutterstock Cirugía de columna. Ortopedia y Traumatología: Cervical Myelopathy Exercises for Cervical Spondylosis With Foraminal Stenosis | LIVESTRONG.COM Xray Image Cervical Spine View Shows Stock Photo (Edit Now) 365092436 - Shutterstock Cervical Spondylosis (Arthritis of the Neck) / Neck Pain & Pinched Nerve / Dr Mandell Cervical Spondylosis - An Ayurvedic Perspective - YouTube

★リンクテーブル★

リンク元	「CS」「頚椎症」「変形性頚椎症」「頚部変形性脊椎症」
関連記事	「cervical」

「CS」

Spondylosis
Classification and external resources
Specialty	Neurosurgery, Orthopedics
ICD-10	M47
ICD-9-CM	721
OMIM	184300
DiseasesDB	12323
MedlinePlus	000436
eMedicine	neuro/564
Patient UK	Spondylosis
MeSH	D013128