What is sympathetic cervical spondylosis?

This condition refers to a clinical syndrome caused by degenerative changes in the cervical spine, leading to osteophyte proliferation in the intervertebral foramina or transverse foramina. These protruding growths stimulate or compress the sympathetic nerves in these areas.

However, this type of cervical spondylosis rarely occurs alone in clinical practice and often coexists with vertebral artery-type cervical spondylosis. There is considerable debate over whether this subtype should be defined separately. Internationally, this concept is almost nonexistent, and recent domestic expert consensus also classifies it under other types of cervical spondylosis without a separate definition. This definition may be abandoned in the future, but here we briefly explain it based on the traditional definition.

Which department should be consulted for sympathetic cervical spondylosis?

English name: sympathetic cervical spondylosis.

Aliases: sympathetic-type cervical spondylosis, sympathetic cervical spondylosis.

Departments to visit: Neurology, Spinal Surgery, Orthopedics, Neurosurgery.

What causes sympathetic cervical spondylosis?

Non-specific degenerative changes in the cervical spine can lead to intervertebral disc degeneration, reactive bone hyperplasia in the uncovertebral and intervertebral joints, etc. Osteophyte proliferation in the intervertebral foramina or transverse foramina may stimulate or compress the sympathetic nerves located there, causing clinical symptoms. It often coexists with other types of cervical spondylosis.

Who is commonly affected by sympathetic cervical spondylosis?

Adults, particularly middle-aged and elderly individuals.

What are the main symptoms and manifestations of sympathetic cervical spondylosis?

This condition rarely occurs alone and is often accompanied by other types of cervical spondylosis, such as vertebral artery-type cervical spondylosis.

The main manifestations include sympathetic nerve excitation or inhibition symptoms, such as occipital headache (usually unilateral, dull or throbbing, with a burning sensation). It may also be accompanied by pain behind the eyeball on the affected side, eyelid weakness, blurred vision or tearing, tinnitus, ear fullness, stinging or foreign body sensation in the throat, as well as autonomic symptoms like nausea, vomiting, sweating, and salivation.

Since sympathetic nerve fibers from the cervical spinal cord participate in the motor and nutritional innervation of the heart, coronary arteries, and aorta, some patients may experience precordial pain that cannot be relieved by vasodilators like nitroglycerin, known as pseudoangina.

How is sympathetic cervical spondylosis diagnosed?

Diagnosis mainly relies on medical history and physical examination. Cervical X-rays may reveal cervical osteophytes, while MRI may show cervical disc degeneration. Additional cervical CT or MRI examinations help assess concurrent cervical spondylosis (e.g., myelopathy or vertebral artery type) and exclude other diseases for diagnosis.

How is sympathetic cervical spondylosis treated?

Treatment primarily includes non-surgical and surgical approaches. Non-surgical treatments include cervical traction or soft cervical collars and symptomatic therapy. Surgical intervention requires evaluation of indications. Local nerve block is also one of the treatment options.

What is the prognosis for sympathetic cervical spondylosis?

The prognosis is relatively good. However, if combined with other types of cervical spondylosis (e.g., myelopathy or vertebral artery type), adverse outcomes may occur.

How can sympathetic cervical spondylosis be prevented?

Prevention mainly involves avoiding lifestyle habits that accelerate cervical degenerative changes, such as poor neck posture, neck trauma, frequently lifting heavy objects, and lack of exercise.