Cervical spondylosis and nerve root lesions. Incidence at routine necropsy.

Cervical spondylosis is a common condition. It is often associated with brachial neuralgia and occasionally it produces spinal cord compression. Although the bony changes may be very obvious on radiographic examination, clinically the disease may not be severe. The real importance of the bony and soft-tissue changes in this condition lies in their effect on adjacent structures. Although the incidence of myelopathy is low there are very many elderly people who suffer from sensory symptoms in the distribution of the brachial plexus. Most of the pathological studies of cervical spondylosis have dealt with the changes in the intervertebral discs and, although there has been much speculation about the mechanism by which symptoms are produced, the histological appearance of the cervical nerve roots has received little attention. This remarkable omission from the numerous papers on the clinical presentation of brachial neuralgia may possibly be explained by the relative inaccessibility of the nerve roots. We have attempted, first, to determine both the incidence and distribution of degenerative disc disease and apophysial joint arthritis, and secondly, to see if there is any correlation between the bone disease and the histological lesions in the cervical nerve roots.