Definition
Cervical spondylosis is a disorder caused by abnormal wear on the cartilage and bones of the neck (cervical vertebrae) with degeneration and mineral deposits in the discs between the vertebrae (cervical discs).

Incidence, and risk factors :
A previous neck injury (which may have occurred several years prior) can predispose to spondylosis, but the major risk factor is aging. By age 60, 70% of women and 85% of men show changes consistent with cervical spondylosis on X-ray.

Aetio-pathologenesis:
Cervical spondylosis results from chronic degeneration of the cervical spine including the intervertebral discs between the cervical vertebrae. There may be abnormal growths or "spurs" on the vertebrae.

These accumulated changes caused by degeneration can gradually compress one or more of the nerve roots. This can lead to increasing pain in the neck and arm, weakness, and changes in sensation. In advanced cases, the spinal cord becomes involved. This can affect not just the arms, but the legs as well.

Degenerative changes develop in the vertebral column with advancing age. The nucleus pulposus of the intervertebral discs undergo degeneration with reduction in their fluid content, and this results in their collapse and narrowing of the intervertebral spaces. The annulus fibrosus also shows degenerative changes and they protrude backwards behind the vertebral bodies to form ridges. Osteophytes develop from the vertebral bodies and laminae resulting in compression of the nerve roots.
The ligamentum flava lose their elasticity and tend to buckle forwards when the cervical spine is extended. Pressure on the spinal arteries and the vertebral arteries during their course in the bony structures leads to secondary vascular changes which cause their occlusion and ischaemic damage to the cord and lower brain stem.

Clinical features:
Cervical sopndylosis is a common condition seen in day-to-day practice. Though the older age groups are more affected by osteo arthritis, many patients even in the fourth and fifth decades of life may suffer from this disease.
• neck pain (may radiate to the arms or shoulder)
• loss of sensation or abnormal sensations of the shoulders, arms, or (rarely) legs
• weakness of the arms or (rarely) legs
• neck stiffness that progressively worsens
• loss of balance
• headaches, particularly in the back of the head
• loss of control of the bladder or bowels (if spinal cord is compressed) movements of the neck, travel and adoption of certain postures aggravate the pain, which may be intermittent or even constant. There may be weakness and wasting of deltoid, triceps, biceps or forearm muscles.

Diagnosis:
Cervical spondylosis has to be suspected in all cases presenting with cervical cord or root symptoms in persons above the age of 40 years.
Progressive neck pain is a key indication of cervical spondylosis. It may be the only symptom in many cases. Examination often shows limited ability to flex the head toward the side (bend the head toward the shoulders) and limited ability to rotate the head. Weakness or sensation losses indicate damage to specific nerve roots or to the spinal cord. Reflexes are often reduced.
• A spine or neck X-ray shows abnormalities that indicate cervical spondylosis.
• A CT scan or spine MRI confirms the diagnosis.
• A myelogram (X-ray or CT scan after injection of dye into the spinal column) may be recommended to clearly identify the extent of injury.
• An EMG may also be recommended.

Management:

General:
In mild cases, no treatment is required. Symptoms from cervical spondylosis usually stabilize or regress with simple, conservative therapy including a cervical collar to restrict motion.Rarely, intermittent neck traction may be recommended instead of, or in addition to, a cervical collar. This usually consists of a halter-like device placed on the head and neck and attached to pulleys and weights.For severe cases, hospitalization with complete bedrest and traction for 1 or 2 weeks may be needed.

Medicinal:
All the symtoms of cervical spondylosis and the individualising totality of the patient are considered to select the homoeopathic medicines.commonly indicated medicines are:Kalmia latifolia ,Lachnanthes tinctoria ,Rhus toxicodendron ,Cimicifuga racemosa, Bryonia alba , Magnesium phosphoricum , Nux vomica Gelsemium sempervirens , Calcarea fluorica , Phytolacca decandra Rhodium oxydatum nitricum , Strychninum purum , Belladonna Fel tauri, Ignatia amara , Kalium Nitricum, Rhododendron chrysanthum Silicea terra, Sulphur, Thuja occidentalis, Conium maculatum, Asarum europaeum, Causticum, Ammonium carbonicum, Calcarea carbonica Kalium Carbonicum, Paris quadrifolia, Menyanthes trifoliata