Is anterior spurring of the cervical spine similar to arthritis?

Anterior Cervical Spurring and Arthritis

Anterior spurring of the cervical spine is a manifestation of degenerative arthritis (cervical spondylosis), representing osteophyte formation from chronic disc degeneration and facet joint osteoarthritis. These bone spurs develop as part of the same degenerative cascade that characterizes cervical spine arthritis.

Pathophysiology and Relationship

Anterior osteophytes are direct consequences of degenerative disc disease and represent the body's attempt to stabilize an arthritic segment. 1 The formation of these spurs follows a predictable pattern:

• Disc degeneration leads to loss of disc height and abnormal motion, triggering reactive bone formation at vertebral body margins 1
• The anterior longitudinal ligament undergoes calcification and ossification as part of the arthritic process 1
• These changes occur concurrently with facet joint arthritis and posterior element degeneration 1

Clinical Significance

The presence of anterior spurring indicates established degenerative disease with several important implications:

• Anterior osteophytes can compress nerve roots and spinal cord, causing radiculopathy or myelopathy identical to other forms of cervical arthritis 1
• Pain from anterior spurring stems from the same inflammatory and mechanical processes as other arthritic changes in the cervical spine 1
• Surgical removal of anterior spurs during anterior cervical discectomy and fusion addresses both the disc pathology and arthritic bone compression 1

Diagnostic Considerations

Plain radiographs readily demonstrate anterior osteophytes, but MRI provides superior assessment of associated soft tissue pathology including disc degeneration, ligamentous changes, and neural compression. 2

• Anterior spurring visible on lateral cervical radiographs confirms degenerative arthritis is present 2
• The size and location of spurs correlate with symptom severity when they compress neural structures 1
• Progressive spurring indicates ongoing degenerative disease requiring monitoring 3, 2

Treatment Implications

Conservative management for symptomatic anterior spurring follows standard arthritis protocols, but surgical intervention specifically addresses mechanical compression when neurological symptoms develop. 1

• Anterior cervical discectomy with spur removal and fusion provides definitive treatment when conservative measures fail 1
• The surgical approach directly removes both the arthritic disc and compressive anterior osteophytes through the same anterior exposure 1
• Fusion rates and outcomes after spur removal parallel those of standard anterior cervical arthrodesis for degenerative disease 4

Important Caveats

Do not confuse anterior spurring with diffuse idiopathic skeletal hyperostosis (DISH), which produces flowing anterior ossification across multiple levels without disc space narrowing. True degenerative anterior osteophytes occur at individual motion segments with corresponding disc degeneration, while DISH represents a distinct systemic condition.

In rheumatoid arthritis patients, anterior spurring may coexist with inflammatory erosive changes, requiring different management strategies. 3, 2 These patients develop both degenerative and inflammatory pathology, with the inflammatory component potentially requiring immunosuppressive therapy alongside mechanical interventions.