Summary

• Osteoarthritis of the spine includes the spontaneous degeneration of either disc or facet joints; an equivalent term is cervical spondylosis or cervical degenerative joint disease (DJD).
• Presenting symptoms include axial neck pain and neurological complications.
• The most common neurological complication is cervical spondylotic radiculopathy (CSR). This results in a pattern of arm pain (specific to the nerve root involved) along with mild weakness and sensory loss in muscles and skin innervated by that nerve root.
• The next most common neurological complication is loss of neurological function from pressure on the spinal cord in the cervical region (cervical spondylotic myelopathy, CSM). Though this loss of function can be painful, there is usually a painless reduction of upper extremity (and sometimes lower extremity) function, which is particularly noticeable as hand clumsiness or loss of fine motor function.
• Treatments differ radically depending on patient presentation, specific symptoms, and which arthritis-related or neurological complications predominate.
• Neurological complications may respond to surgical decompression if symptoms do not abate after treatment with conservative measures, depending on their longevity and severity.