The posterior longitudinal ligament becomes fibrotic. The ligamentum flavum hypertrophies, looses its elasticity, and buckles into the spinal canal. Together, these changes narrow the neural foramina and spinal canal and result in compression of the nerve roots, spinal cord, and their associated arteries and veins. Compression of the nerve roots can result in radiculopathy and compression of the spinal cord in myelopathy . Clinical Presentation Cervical spondylosis often presents with one or more symptoms including neck pain, arm pain, paresthesias or weakness in the arms or hands, instability of gait, or bowel and bladder dysfunction.
Patients usually complain of neck pain radiating into the shoulder, arm or scapula.
When asked, they can often draw out a dermatomal pattern which can help localized the level involved. Other complaints include paresthesias and weakness in the shoulder, arm, or hand. Occasionally, the radiculopathy may present as painless paresthesias and numbness. Symptoms may develop acutely, often after minor trauma, or be recurrent, or insidiously or rapidly progressive. Complaints include stiffness, heaviness, or weakness in legs, cramping and muscle spasms, and easy fatigueability.