Uncovertebral spurring, also known as uncinate process osteophytes or Luschka joint spurring, refers to the formation of small, bony growths in the cervical spine (neck). This condition is a common result of age-related changes and wear and tear within the spine. These bony projections are a manifestation of the body’s attempt to stabilize a degenerating spinal segment. While the presence of these spurs is extremely common, they only become a health concern when their size or location affects nearby nerves or blood vessels.
Understanding the Uncovertebral Joints and Osteophyte Formation
The uncovertebral joints, frequently called the joints of Luschka, are small articulations unique to the cervical spine, specifically found between the C3 and C7 vertebrae. These joints form where the superior, hook-like projections of one vertebral body, called the uncinate processes, meet the beveled, inferior surface of the vertebra above it. They are not present at birth but develop in early childhood as the spine begins to bear weight and experience movement.
The primary function of these joints is to guide neck motion, permitting flexion and extension while limiting excessive side-to-side bending and rotation. They also provide a protective boundary for the intervertebral discs, helping to prevent the discs from slipping out laterally. Uncovertebral spurring occurs when the body develops osteophytes, which are bony overgrowths, specifically around the margins of these joints.
An osteophyte is a smooth, rounded projection of extra bone tissue that forms in response to instability or stress at a joint. When this bone growth occurs at the uncovertebral joint, the resulting spur bulges into the surrounding space. These spurs can be visualized on imaging, appearing like small, bony ledges extending from the vertebral body.
The Mechanisms Driving Degenerative Spurring
The formation of these bony spurs is a hallmark of cervical spondylosis, the umbrella term for age-related degenerative changes in the neck’s spinal structures. The process typically begins with the intervertebral discs, the fluid-filled cushions between the vertebrae. With age, the discs lose water and proteoglycans, causing them to dehydrate, flatten, and lose height.
This loss of disc height fundamentally alters the spine’s biomechanics. The reduced cushion causes the axial load (the weight transmitted down the spine) to shift away from the disc and onto the facet and uncovertebral joints. This chronic, abnormal mechanical stress placed on the uncovertebral joints initiates a reactive process.
The body interprets this excessive motion and stress as instability and attempts to stabilize the segment by laying down new bone. This biological response results in the formation of osteophytes at the joint margins, effectively stiffening the area to reduce motion. The growth of this extra bone is an attempt to create a more stable, albeit less mobile, spinal column.
Clinical Presentation and Associated Symptoms
Uncovertebral spurs often remain asymptomatic, causing no pain or functional issues. However, if the bony growth projects in a direction that encroaches upon adjacent sensitive structures, it can lead to noticeable symptoms. The most common complication arises when the spur grows posteriorly and laterally, narrowing the intervertebral foramen, the small opening where a spinal nerve root exits the spinal canal.
Compression of a nerve root by an uncovertebral osteophyte causes cervical radiculopathy. Patients typically experience sharp or electric-like pain that originates in the neck and radiates down the shoulder, arm, and hand in a specific nerve pattern. This pain may be accompanied by sensory changes, such as tingling, numbness, or a “pins-and-needles” sensation in the affected limb.
If the compression is severe or long-standing, it can lead to motor deficits, manifesting as muscle weakness in the arm or hand supplied by the pinched nerve. In more serious cases, the spurs can project inward, narrowing the central spinal canal and potentially compressing the spinal cord itself, a condition known as cervical myelopathy. Symptoms of myelopathy include balance difficulties, gait disturbances, and loss of fine motor skills in the hands.
Treatment and Management Strategies
The management of uncovertebral spurring focuses primarily on alleviating symptoms and preserving neurological function when compression is present. Initial treatment is typically conservative and non-surgical.
Physical therapy is a primary component, aiming to strengthen the neck muscles, improve posture, and increase the range of motion. Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to reduce localized pain and inflammation stemming from the irritated joint or nerve root. For intense inflammation, a physician may recommend a corticosteroid injection, which delivers anti-inflammatory medication directly to the affected nerve root area. Other conservative measures include the application of heat or ice and the temporary use of a soft cervical collar.
Surgery is generally considered a last resort, reserved for individuals who experience progressive neurological deficits (such as worsening muscle weakness) or whose pain fails to improve after an extended period of conservative treatment. Surgical procedures aim to decompress the trapped nerve root or spinal cord. This may involve a foraminotomy, which enlarges the nerve root opening, or a discectomy with fusion, which removes the spur-forming structures and stabilizes the spinal segment.