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Treatments and drugs
By Mayo Clinic staff
Without treatment, the signs and symptoms of cervical spondylosis may decrease or stabilize, or they may worsen. The goal of treatment is to relieve pain and prevent permanent injury to the spinal cord and nerves.
Treatment of mild cases
Mild cases of cervical spondylosis may respond to:
- Wearing a neck brace (cervical collar) during the day to help limit neck motion and reduce nerve irritation.
- Taking nonsteroidal anti-inflammatory drugs such as ibuprofen (Advil, Motrin, others) for pain relief.
- Doing exercises prescribed by a physical therapist to strengthen neck muscles and stretch the neck and shoulders. Low-impact aerobic exercise, such as walking or water aerobics, also may help.
Treatment of more serious cases
For more severe cases, nonsurgical treatment may include:
- Hospitalization with bed rest and traction on the neck for a week or two to completely immobilize the cervical spine and reduce the pressure on spinal nerves.
- Taking muscle relaxants, such as methocarbamol (Robaxin) or cyclobenzaprine (Flexeril), particularly if neck muscle spasms occur.
- Injecting corticosteroid medications into the joints between the vertebrae (facet joints). The injection combines corticosteroid medication with local anesthetic to reduce pain and inflammation.
Surgery
If conservative treatment fails or if your neurological signs and symptoms, such as weakness in your arms or legs, are getting worse, you may need surgery. The surgical procedure will depend on your underlying condition, such as bone spurs or spinal stenosis. The most common surgical options include:
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Frontal approach (anterior). Your surgeon makes an incision in the front of your neck and moves aside the windpipe (trachea) and swallowing tube (esophagus) to expose the cervical spine. Your surgeon can then remove a herniated disk or bone spurs, depending on the underlying problem. Sometimes, with disk removal, your surgeon will fill the gap with a graft of bone or other implant.
With the anterior approach, your surgeon can relieve pressure on your spinal cord from bone or from multiple disk protrusions by removing two disks and the bone between them (corpectomy). Then, to support your head and neck, your surgeon reconstructs the area with bone from your body or a bone bank or with an implant made of metal combined with bone.
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Back approach (posterior). Your surgeon may opt to remove or rearrange bone from the back of your neck, especially if several portions of the channel that houses the cord have narrowed. The operation, called a laminectomy, removes the back part of the bone over the spinal canal through an incision in the back of your neck.
Laminoplasty, an alternative to laminectomy, involves cutting and moving pieces of vertebrae to make more room for the spinal cord. Although laminoplasty takes longer, it is less likely to leave the neck unstable.
Risks of surgery
Risks of these procedures include infection, a tear in the membrane that covers the spinal cord at the site of the surgery, bleeding, a blood clot in a leg vein and neurological deterioration. In addition, the surgery may not eliminate all the problems associated with your condition.
