New England Journal of Medicine- 9th JULY2020

Degenerative cervical spondylosis is a chronic, progressive deterioration of osseocartilaginous components of the cervical spine that is most often related to aging.

Radiographic evidence of degeneration of the cervical spine occurs in virtually all persons as they age;
however, not all persons have the typical symptoms of neck pain or neurologic deficits that correspond to the mechanical compression of neural elements.

Symptomatic cervical spondylosis is initially managed with nonsurgical treatment options, which usually result in abatement of symptoms.

Surgical intervention may be indicated if there is clinically significant neurologic dysfunction or progressive instability or deformity of the cervical spine. No currently approved therapy addresses the cause of degenerative cervical spondylosis or reverses the deterioration. In select patients, surgical intervention can lead to favorable outcomes.

Conclusions and Recommendations

Degenerative cervical spondylosis is caused by arthritic changes in the osseocartilaginous components of the cervical spine, which may compress spinal nerve roots, the spinal cord, or both, causing neck pain, radiculopathy, or myelopathy.
Treatment is generally nonsurgical, especially for pain and mild radiculopathy, which are typically self-limiting.
However, surgery is generally indicated to treat myelopathy and may be indicated for persistent and severe nerve-root compression.