Cervical Spondylosis is commonplace in older adults but many do not present any signs and symptoms. (1)
Cervical spondylosis is caused due to degeneration of the vertebras and intervertebral discs of the cervical spine. It occurs due to a variety of causes and likewise, it can present in many different ways with different symptoms. (2)
Can Cervical Spondylosis Cause A Stroke?
While having the chance of stroke in the case of cervical spondylosis, it is possible. There is a pair of vertebral arteries each arising from the subclavian artery on both sides. It is the chief supplier of the spine as it goes backward and supplies the spinal cord and vertebral column. They give rise to anterior spinal arteries which are responsible for the blood supply of the anterior part of the spinal cord. The rest of the vertebral artery joins from both sides into a single artery known as a basilar artery which gives branches to supply the posterior cerebral circulation and brain stem. (2)
In the cases of cervical spondylosis, when there is a spur formation it can press upon the vertebral artery or its branches and can lead to reduced flow of blood or blockage of the vessel leading to ischemia of the area supplied by it. Since it is responsible for supplying brain stem and posterior cerebral areas, it can lead to the causation of ischemic stroke. The phenomena occurring is also known by the name of vertebrobasilar insufficiency because there is reduced blood flow in the vertebral and basilar arteries (2).
Does Cervical Spondylosis Cause Paralysis?
Since there is the involvement of the spine in the condition of cervical spondylosis, it is very much likely that it can cause nerve compression leading to paralysis ultimately. There can be involvement of sensory, motor, or posterior column tracts and upon different levels depending upon the site and extent of involvement. It can also cause multiple tract involvement at the same time in later stages with autonomic involvement and bladder/bowel incontinence.
There can be a variety of spinal cord syndromes leading to a different type of paralysis that can occur in cervical spondylosis such as: –
Motor Syndrome: – there is the involvement of the corticospinal tract occurring due to the collapse of the vertebral body and leading to the failure of transmission of nerve impulse to the muscles controlled by it.
Central Cord Syndrome: – it can lead to both sensory and motor system failures due to the involvement of corticospinal as well as spinothalamic tracts but is usually restricted in the upper body because the tract involvement is from inside to outside. The upper body tracts are involved earlier and posterior columns are usually spared.
Brown Sequard Syndrome: – in this lesion, there is complete hemisection or destruction of half of the spinal cord at the involved level. It leads to the destruction of all the tracts whether coming down or going upwards at the side involved. There are the motor and posterior column failures on the same side of the body but the sensory involvement is on the opposite side.
Transverse Lesion Syndrome: – there is complete spinal cord involvement at the site which includes both sides of the sensory, motor, and posterior column involvement. There is a large amount of deficit occurring in this syndrome and usually is seen in very late and complicated cases of cervical spondylosis. It is very difficult to treat and cannot be cured completely (3).
Conclusion
Cervical spondylosis can produce a lot of symptoms ranging from simple headache/neck pain to complete paralysis of the body below the level of the neck. It is known to cause stroke also by creating a vertebrobasilar insufficiency due to compression of vertebral arteries. It is also known to cause a variety of paralysis and can lead to a different type of tracts involvements which varies the symptoms. But it is usually occurring in untreated cases having complications otherwise it is a fairly controllable disease.
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