Uncovertebral osteophytes are bony outgrowths, commonly known as bone spurs, that develop specifically within the cervical spine, or neck. These formations are a common radiographic sign of cervical spondylosis, the medical term for age-related degeneration of the neck bones and discs. The presence of these osteophytes indicates a structural change in the spine, often occurring as part of the natural aging process.
Understanding the Uncovertebral Joint
The uncovertebral joints, also called the Joints of Luschka, are small, paired articulations found in the cervical spine between the C3 and C7 vertebrae. They are unique to the neck region and develop over time, not being present at birth.
These joints are formed where the uncinate processes, which are hook-shaped projections on the superior surface of the lower vertebrae, meet the body of the vertebra above. Their primary function is to guide motion, limiting excessive sideways bending and movement within the neck. This arrangement provides stability and helps protect the intervertebral discs from prolapsing laterally. They also contribute to forming the medial wall of the intervertebral foramen, the small passageway through which nerve roots exit the spinal cord.
Why These Bony Spurs Form
The development of uncovertebral osteophytes is primarily a response to chronic, degenerative changes within the cervical spine. Intervertebral discs lose hydration and height, becoming less effective as shock absorbers, a process that can start as early as a person’s twenties.
This loss of disc height places increased mechanical stress on the adjacent uncovertebral joints. The body attempts to stabilize the segment by producing new bone tissue, interpreting the excessive stress and instability as a need for reinforcement.
This process results in the formation of osteophytes at the margins of the uncovertebral joint. It is closely linked to osteoarthritis of the spine, often referred to as cervical spondylosis. As degeneration progresses, the osteophytes become larger and more prominent, reflecting the body’s attempt to limit motion at the unstable segment.
How Uncovertebral Osteophytes Cause Symptoms
Many individuals have uncovertebral osteophytes visible on imaging scans without experiencing pain or symptoms. The bone spur itself is generally not the source of discomfort. Symptoms arise only when the growth enlarges sufficiently to encroach upon nearby neurological structures. The direction in which the osteophyte projects determines the type and severity of the clinical manifestation.
Lateral Projection (Cervical Radiculopathy)
When a bone spur projects laterally, it narrows the intervertebral foramen, the opening for the spinal nerve root. This compression, known as cervical radiculopathy, typically causes radiating symptoms into the shoulder, arm, or hand, often on one side of the body. Patients may experience sharp, shock-like pain, along with tingling, numbness, or muscle weakness in the distribution of the affected nerve.
Central Projection (Cervical Myelopathy)
A more serious outcome occurs when an osteophyte projects centrally, narrowing the spinal canal itself. This condition, called cervical myelopathy, places pressure directly on the spinal cord. Symptoms can include difficulty with fine motor skills, such as buttoning a shirt or writing, along with problems with gait and balance. Myelopathy symptoms, including leg stiffness and instability, tend to be more diffuse and represent neurological compromise.
Identifying the Condition and Treatment Paths
Diagnosis begins with a medical history and physical examination, focusing on the location of pain, radiating symptoms, and assessment of reflexes and muscle strength. Imaging tests confirm the presence and assess the extent of the bony changes. Plain X-rays visualize the osteophytes and overall degenerative changes in the cervical spine. A Computed Tomography (CT) scan provides a detailed view of the bone structure, useful for measuring the degree of bony encroachment on the spinal canal or nerve root foramen. Magnetic Resonance Imaging (MRI) evaluates soft tissues, such as the spinal cord, nerve roots, and intervertebral discs, to determine if they are being compressed by the osteophytes.
Treatment for symptomatic uncovertebral osteophytes typically begins with conservative, non-surgical management. Nonsteroidal anti-inflammatory drugs (NSAIDs) or other over-the-counter pain relievers are used to manage pain and reduce inflammation. Physical therapy is a primary component of care, focusing on exercises to strengthen the neck muscles, improve posture, and increase mobility without causing irritation.
A doctor may also recommend localized treatments, such as a corticosteroid injection, to deliver anti-inflammatory medication directly to the source of nerve irritation. Surgery is generally reserved for cases where non-surgical treatments have failed to relieve persistent and severe pain, or when there is evidence of progressive neurological deficits, such as worsening weakness or myelopathy. Surgical procedures, which may involve removing the bone spur to decompress the nerve or spinal cord, are designed to create more space around the affected neural structures.