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Spondylosis: All You Need To Know
Spondylosis is a type of arthritis that occurs when discs and joints degenerate, when bone spurs grow on the vertebrae, or both. These changes can impair the spine's movement and affect the nerves and other functions.
Cervical spondylosis is the most common type of progressive disorder that affects the neck during aging.
According to the American Academy of Orthopaedic Surgeons, more than 85% of people over 60 years old have cervical spondylosis.
Other types of spondylosis develop in different parts of the spine:
The effects of spondylosis vary among individuals, but they do not usually cause serious issues.
When a person has symptoms, these are often pain and stiffness that tend to come and go.
Spinal osteoarthritis is another term for spondylosis. Osteoarthritis describes arthritis that results from wear and tear. It can affect any joint in the body.
The spine helps give the body structure and supports most of its weight. It also carries and protects almost all of the main nerve branches that run from the brain.
The spine is curved, not straight, and the cervical, thoracic, and lumbar parts of the spine contain 24 bones known as vertebrae.
Between these vertebrae are joints that allow the spine to move flexibly. These are called the facet joints.
In addition, soft, rubbery tissue called intervertebral discs separate the vertebrae. These consist of cartilage endplates and a tough exterior, the annulus fibrosus, surrounding an inner core, the nucleus pulposus.
Intervertebral discs help achieve smooth movement, and they cushion against any impact on the bones.
As a person ages, the discs become drier, thinner, and harder, and they lose some of their cushioning ability. This is why an older person is more likely to have a compression fracture of the vertebra than a younger person.
A vertebral compression fracture results from bone collapsing in the spine. It commonly occurs with osteoporosis.
The facet joints between the vertebrae also function less well with age due to wear and tear on their cartilage surfaces.
As the cartilage erodes, the bones start to rub together, causing friction. This can result in the formation of bony growths called bone spurs.
The loss of rubbery tissues and the development of spurs make the spine stiffer. Movement of the back also becomes less smooth, and friction increases.
Daily wear and tear over time is the general cause of spondylosis.
These changes affect people differently, depending on each individual's risk factors.
Risk factors include:
Most people with age-related spondylosis do not experience any symptoms. Some people have symptoms for a while, but then they go away. Sometimes, a sudden movement can trigger symptoms.
Common symptoms are stiffness and mild pain that worsens following certain movements or long periods without moving, such as sitting for a long time.
More severe symptoms include:
Some initial changes or symptoms help doctors determine what type of spondylosis a person has. In other people, these same issues can develop into complications.
Below are examples of spinal changes that doctors look for in diagnosis:
These changes can worsen other symptoms. The location of symptoms, such as pain, will depend on the part of the spine that spondylosis affects.
Most cases of spondylosis produce only mild, occasional stiffness and pain, and they do not need treatment.
Home remediesIf a person experiences pain, they can try the following:
Some people use the following to manage symptoms:
Research indicates that some of these complementary therapies may provide relief for nerve pain or damage that stems from the neck.
MedicationsIf pain is severe or persistent, a doctor may suggest:
A steroid injection aims to relieve pain by reducing inflammation. Using X-ray guidance, the doctor will inject the steroid into the roots of the affected nerves.
However, steroids can also have adverse effects, so a doctor will usually try to limit their use.
It is essential for individuals to follow the doctor's advice when using medications.
A doctor will only suggest surgery if symptoms are severe and persistent and if no other treatment has helped.
A person might need surgery if pinched nerves result in serious numbness, weakness, or loss of bowel or bladder control and if the damage is likely to worsen without surgery.
The type of surgery will depend on the symptoms and their locations. A doctor can identify the affected areas with imaging technology, such as X-rays.
Surgery might involve removing a disc or piece of bone that is pressing against the nerves and then fusing nearby vertebrae. Or, a surgeon may replace a damaged disc with an artificial one.
In the past, spinal surgery was a major procedure. Now, endoscopic — or keyhole — surgery may be an option. This is far less invasive than open surgery.
According to the American Association of Neurological Surgeons, minimally invasive spinal surgery involves fewer risks. This is because:
There is also a reduced risk of pain and infection after surgery and less need for medication.
Minimally invasive spinal surgery is often an outpatient procedure, which means that many people return home the same day.
However, most people with spondylosis do not need surgery. A doctor will discuss the risks of spinal surgery, compared with the potential benefits.
Spondylosis is a common issue that affects the spine, and most people are likely to develop some degree of spondylosis as they age. Many will not experience symptoms, or symptoms will be mild. This can include pain and stiffness that tend to come and go.
However, if pain worsens or a person experiences severe numbness and weakness that affects quality of life, a doctor may recommend surgery.
IVDD In Dogs: Symptoms And Treatments
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If you have a dog with short legs and a long back, you may want to start looking for signs of intervertebral disc disease (IVDD).
This neurological condition is characterized by back pain and limited mobility in dogs. It's commonly observed in dachshunds, basset hounds, Shih Tzus, French bulldogs, beagles and other similar dog breeds due to their long body type and stubby legs. However, it is not limited to small dogs—it can also affect large breeds, such as the German shepherd.
Read on to learn more about IVDD, including symptoms, causes and treatments available. Keep in mind that purchasing one of the best pet insurance policies can help keep your pooch—and wallet—protected from injuries and illnesses, including IVDD.
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What Is IVDD in Dogs?Intervertebral disc disease, or IVDD, is a condition that occurs when the cushioning between the vertebrae (bones of the spinal cord) that are meant to absorb shock and cushion the spinal cord begin to harden and either "bulge or burst," says Dr. Maren Krafchik, D.V.M., director of medical operations for the ASPCA Animal Hospital.
You can think of intervertebral disc structures similar to a jelly donut—they have a hard, cushioned outside and gelatinous inside.When that jelly inside hardens up over time,your dog's spinal discs can rupture or become displaced, making it painful or even impossible for them to walk.
Not only is IVDD painful for your pup, but it's also dangerous and can lead to other spinal injuries, such as disc herniation or spinal compression.
Symptoms and Behaviors of Dogs With IVDDSymptoms of IVDD in dogs usually occur slowly and gradually, sometimes over several days or weeks. Not all owners may notice these symptoms, as the dog may just lay around for a few days to try and heal the injury themselves. However, in extreme cases, the disc can rupture suddenly, with some dogs losing their ability to walk in less than an hour.
If you observe any of the following behaviors or symptoms of IVDD in your dog, you should contact your veterinarian right away:
There are three different types of IVDD that can occur in dogs: Hansen type I, II and III. Here is a brief overview of each:
Hansen Type IThis type of IVDD is commonly referred to as a "slipped disc." It occurs when the center of the disc becomes hardened and loses its flexibility, which can lead to damage and degeneration. In this case, your dog will experience a great deal of pain and suffer from limited movement. Some cases of Hansen type I IVDD can cause permanent damage, so if you suspect there's an issue with your dog's spine, take them to their veterinarian right away.
Hansen type I IVDD is most common in small dogs with long backs and disproportionate limbs such as dachshunds, corgis, poodles, beagles or basset hounds between the ages of 3 to 6, according to VCA Animal Hospitals.
Hansen Type IIMore commonly found in larger breeds such as German shepherds, Doberman pinschers and Labrador retrievers, and typically occurs between the age of 8 to 10 years old. This type of IVDD occurs more slowly than Hansen type I IVDD. Over the course of months or even years, the disc collapses and presses against the spinal cord, causing long-term pain and injury.
Hansen Type III (Trauma-Related Injury)Much less common than Hansen types I or II, type III occurs due to a sudden and traumatic injury. Described as a "low volume, high velocity" herniation, it's caused by intense exercise or trauma that causes excessive force on the spinal disc. This results in pain for your dog, and difficulty walking—ranging from poor control of the back legs to complete paralysis, or in some severe cases, the development of myelomalacia, or the softening and death of the spinal cord.
What are the Stages of IVDD in Dogs?There are five stages of IVDD in dogs based on symptoms, and each stage determines the course of treatment. Here is a brief overview of what each stage looks like.
Stage one: Dogs in stage one of IVDD will experience mild pain without neurological deficits, according to Krafchik. They can still walk and have a high chance of full recovery.
Stage two: This stage includes moderate to severe pain in the neck or lower back of your dog. Your pet can still probably walk during this stage, however, they may be weaker and knuckled over. Fortunately, dogs in this stage also have an elevated chance of full recovery.
Stage three: Dogs with stage three IVDD will experience paresis, or difficulty placing their legs on the ground. "Signs of paresis include difficulty walking, incoordination, or inability to stand," Krafchik says. In these cases, the success rates are slightly lower and surgery is often recommended.
Stage four: Pets with stage four IVDD will experience complete paralysis. They are unable to move their legs but will still be able to feel pain, according to Krafchik. Surgery is highly recommended and there is roughly a 50% chance of success to revitalize movement in their legs.
Stage five: Dogs in stage five will have complete paralysis, meaning they cannot move their limbs and have no pain perception. "Stage five signals the loss of deep pain as elicited on deep pinching of their toes or bone," Krafchik says. Dogs in this stage require surgery, and success levels for recovery are low.
How to Test for IVDD In DogsAs far as IVDD diagnosis goes, the earlier the better, as an early diagnosis can help improve your pet's odds of recovery.
To diagnose your dog with IVDD, you must seek medical assistance from your veterinarian. They will typically start with a thorough physical examination to pinpoint the location of the problematic disc in the spine and where your pooch is feeling pain the most and to evaluate the severity of their situation.
While it may be easy to strongly suspect IVDD as the cause of the symptoms, a confirmed diagnosis will require order imaging of the spine, usually through a radiograph or magnetic resonance imaging (MRI). However, in some cases, additional blood work or screenings may be necessary to eliminate other reasons your pet may be in pain.
Treatment Costs for Dogs With IVDDFortunately, most mild cases of IVDD have affordable treatment costs,, as it usually includes simply preventing your dog from jumping, cutting back on playtime, maintaining your dog's body weight at a healthy level and giving them crate rest.
For more severe cases, the recovery timeline will vary. Dogs that still have mobility and are able to feel pain pre-surgery will typically return to normal after two to three months with post-op rehabilitation such as acupuncture for pain management, physical therapy or massage therapy sessions for muscle strengthening, or treatments for inflammation management and healing.
Your veterinarian may prescribe medications to reduce the pain, swelling and inflammation, such as a non-steroidal anti-inflammatory medication like carprofen, which typically costs around $12, depending on the dosage. They may also prescribe anxiety relief pills to help your dog get the rest they need, such as gabapentin, which also costs around $12, on average.
Surgery for IVDD aims to remove the damaged disc material and reduce spinal pressure to improve blood flow and prevent future injury. This can cost anywhere from $3,000 to $8,000 depending on where you live and the individual veterinary practice. In addition, owners are advised to continue physical therapy and exercise restrictions post-op to help their dog heal. Here is a breakdown of what these costs may look like, according to Fetch Pet:
IVDD can be a costly disease in dogs due to the many diagnostic tests, treatments or surgery required to repair a dog's spine. Luckily, many of the best pet insurance policies will cover these costs as long as it is not a pre-existing condition. It's a good idea to shop around and find the right policy for your dog's needs and purchase it before something happens, especially if they're a breed prone to this disease.
What Is the Life Expectancy of Dogs With IVDD?Fortunately, most dogs with mild to moderate IVDD will recover with rehabilitation or surgery, Krafchik says. However, the odds decrease for those with more severe spinal injuries.
IVDD often occurs relatively slowly, typically over several days or weeks; however, there are cases of discs rupturing very suddenly, so it is important to keep a watchful eye on your dog and take note of any potential indications of IVDD. It is also important to note that your dog can have a slipped disc on the same disc more than once, or in another adjacent disc.
Is IVDD Common in Senior Dogs?IVDD in senior dogs is not uncommon, as this disease is a degenerative process associated with aging.
"IVDD is a common source of back pain in older dogs,", Krafchik says. Particularly for predisposed breeds, such as the German shepherd, IVDD is much more common as they reach their older years. However, it's important to note that IVDD for dogs can occur at any stage of life and is not uncommon for younger dogs.
Can You Prevent IVDD In Dogs?Unfortunately, there is no way to completely prevent IVDD in your dog.
"For some dogs, no matter what an owner does, they may still have IVDD," Krafchik says. However, if you know that your dog is a predisposed breed you can take some precautions such as keeping your pet at a healthy weight, using harnesses instead of neck leashes, restraining your dog from jumping on and off furniture, or limiting high-impact activities.
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Bottom Line IVDD is, fortunately, a treatable but costly disease. When given medical treatment or surgery, most dogs can expect to make a full recovery. That's why it is important to monitor your dog for symptoms and catch them early on, and consider investing in the financial cushion of pet insurance before the fact.
Other Common Health Conditions in Dogs:DePuy Launches New Interbody Implant For Degenerative Disc Disease
DePuy Synthes, an orthopedic and neurosurgery company owned by Johnson & Johnson, recently announced the launch of their new flagship technology, the CONCORDE LIFT Interbody Implant. The new implantable device was designed to help treat patients suffering from degenerative disc disease, a condition that can cause extreme pain from a damaged disc in the spine.
The implantable device was designed as part of a new procedural solution that can simplify minimally invasive spine surgery procedures used to help restore disc height in the spinal column. This is typically done through the process of spinal fusion, a surgical procedure that places bone or bone-like material within the space between two spinal vertebrae. In an effort to simplify the procedure, DePuy created the CONCORDE LIFT implant to provide patients with a device that can specifically fit each patient's anatomy due to a continuous expansion mechanism.
"To help treat patients suffering from advanced degenerative disc disease, the degenerated disc is first removed, and then the CONCORDE LIFT Expandable Interbody device is inserted and expanded, with the procedural aim of restoring height of the disc space," said Nadav Tomer, worldwide president of DePuy Synthes. "The device is an expandable titanium cage with instrumentation that delivers control and performance to clinicians through tactile feedback and reliable graft delivery. It is designed with a continuous expansion mechanism, which allows the surgeon to specifically fit the intervertebral cage to the patient's anatomy, creating a more personalized solution."
Perhaps the most novel part of the technology comes after the implant is inserted and the surgeon creates the necessary expansion. After implantation, the device can then be backfilled with bone graft to maximize bone graft contact and containment, which will help promote bone growth and increase the chances of successful spinal fusion.
"The key difference compared to the majority of other expandable cages on the market is the fact that the CONCORDE LIFT can be backfilled with bone graft post-expansion," Tomer said. "One of the key requirements for successful fusion is adequately packing the disc space with bone graft, which promotes adequate bone graft-endplate contact. Even though the disc space is typically pre-filled with bone graft prior to cage expansion, an additional void is created when the cage gets expanded. By using the post expansion backfilling technique, in which the bone graft can be pushed through the inserter into the implant and disc space, this void created by the expansion of the device can be filled to create a more homogenous bone environment for spinal fusion to occur."
The implant itself is made from a medical grade titanium alloy, one of the most commonly used titanium alloys, and is currently used in a variety of different medical applications. The company recently conducted an anatomic lab study using the device and found that the implant saved significant procedure time during disc removal, cage implantation, and screw placement when compared to a control group of current market product offerings. Tomer believes these results will help pave the way toward more minimally invasive treatments for patients suffering from degenerative disc disease.
"By 2020, it is estimated that half of all spinal fusion procedures will be performed using a minimally invasive approach," Tomer said. "While it has a steep learning curve, minimally invasive spine surgery has been associated with reducing complications, blood loss, muscular damage, and pain — all with a faster recovery for patients when compared to conventional open spine surgery. With the launch of the CONCORDE LIFT implant, DePuy Synthes is demonstrating our commitment to innovative offerings that reduce surgical complexity, improve patient outcomes, and potentially lower the cost to deliver quality patient care."
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