From the Guidelines
Spondylosis deformans is a common, age-related degenerative condition of the spine characterized by the formation of bone spurs (osteophytes) along the edges of the vertebrae, which can be identified through imaging modalities such as MRI or CT scans, as discussed in the 2021 update of the ACR Appropriateness Criteria for low back pain 1.
Definition and Characteristics
Spondylosis deformans typically develops as a natural part of the aging process and is considered a normal radiographic finding in many older adults. It occurs when the intervertebral discs begin to degenerate and lose height, causing the vertebral bodies to respond by forming bony projections. While spondylosis deformans is often asymptomatic, some individuals may experience stiffness, reduced range of motion, or mild discomfort.
Diagnosis and Imaging
The diagnosis of spondylosis deformans often involves imaging studies, with MRI being the initial imaging modality of choice for evaluating lumbar pathology, including disc degeneration and the thecal sac and neural structures 1. CT myelography and radiography can also be useful in certain situations, such as assessing the patency of the spinal canal or evaluating spinal deformity.
Treatment and Management
Treatment for spondylosis deformans is generally conservative, focusing on pain management with over-the-counter medications, physical therapy to maintain flexibility and strengthen supporting muscles, and lifestyle modifications including weight management and proper ergonomics. Heat therapy and gentle stretching can also provide relief. The goal of treatment is to manage symptoms and maintain quality of life, as spondylosis deformans is often a chronic condition.
Key Considerations
It is essential to distinguish spondylosis deformans from more severe degenerative disc disease or spinal stenosis, which may cause more significant pain or neurological symptoms. Most people with spondylosis deformans can maintain normal activities with minimal intervention, though consultation with a healthcare provider is recommended if pain becomes persistent or severe. According to the 2021 update of the ACR Appropriateness Criteria for low back pain, patients presenting with subacute or chronic low back pain who have failed 6 weeks of conservative therapy should be imaged if they are believed to be candidates for surgery or intervention or if diagnostic uncertainty remains 1.
From the Research
Definition of Spondylosis Deformans
There are no research papers provided to directly answer the question of what spondylosis deformans is. However, the provided studies discuss related conditions such as spondylolisthesis and spondylolysis.
Related Conditions
- Spondylolisthesis is defined as the forward displacement of one vertebrae upon another, usually at the L5-S1 level, but also occurring at L4-5 2.
- Spondylolysis is a defect of the pars interarticularis of vertebrae, most commonly seen at L5 and L4 3.
- Degenerative spondylolisthesis is a disorder that causes the slip of one vertebral body over the one below due to degenerative changes in the spine 4.
Treatment of Related Conditions
- Conservative management strategies for symptomatic lumbar spondylolisthesis include non-narcotic and narcotic pain medications, epidural steroid injections, transforaminal injections, and physical therapy 5.
- Bracing (thoraco-lumbar-sacral orthosis) has been accepted as a mainstay of treatment for symptomatic spondylolysis and grade I spondylolisthesis, but physical therapy and other non-bracing conservative management techniques can also be effective 6.
- Conservative treatment of spondylolysis in adolescent athletes with cessation of sports, thoracolumbosacral orthosis, and bone stimulator followed by rehabilitation was associated with excellent outcomes in terms of return to sports 3.