Cervical spondylosis is a degenerative condition of the cervical spine resulting from age-related structural changes involving the intervertebral discs, facet joints, uncovertebral joints, ligaments, and vertebral bodies. It represents a spectrum of degenerative pathology rather than a single disease entity and is one of the most common causes of chronic neck pain and stiffness in adults. Progressive degeneration leads to reduced disc height, osteophyte formation, ligament thickening, and altered spinal biomechanics, which may result in pain, restricted mobility, and neurological compromise.

Patients with cervical spondylosis commonly present with axial neck pain and stiffness that worsens with activity, sustained posture, or repetitive movements. Pain may radiate to the shoulders, upper back, or occipital region. Morning stiffness is frequent and typically improves with movement. As degeneration progresses, mechanical pain may be accompanied by neurological symptoms due to nerve root or spinal cord compression.

Cervical radiculopathy occurs when degenerative changes compress exiting nerve roots, leading to radiating arm pain, numbness, tingling, or weakness in a dermatomal distribution. Cervical myelopathy represents a more serious manifestation resulting from spinal cord compression and may present with gait instability, hand clumsiness, fine motor difficulty, upper motor neuron signs, and sphincter dysfunction. Early recognition of myelopathy is critical, as delayed intervention can result in irreversible neurological deficits.

Orthopaedic evaluation involves a comprehensive clinical assessment, including posture analysis, cervical range of motion, neurological examination, and provocative testing. Particular attention is paid to signs of myelopathy, which mandate urgent imaging and specialist review. Imaging plays a central role in diagnosis. Plain radiographs may demonstrate loss of disc height, osteophytes, and alignment changes, while MRI provides detailed evaluation of disc pathology, neural compression, and spinal cord signal changes.

Management of cervical spondylosis is primarily conservative in patients without neurological compromise. Treatment focuses on activity modification, physiotherapy aimed at improving mobility and strengthening cervical musculature, postural correction, and pain management. Education regarding ergonomics and lifestyle modification is essential to reduce mechanical stress on the cervical spine.

Surgical evaluation is indicated in patients with progressive neurological deficits, cervical myelopathy, or persistent radicular pain unresponsive to adequate conservative therapy. Surgical objectives include decompression of neural structures, stabilization of the cervical spine, and restoration of alignment where required. The decision to proceed with surgery is based on clinical severity, imaging findings, and functional impairment rather than imaging alone.

Cervical spondylosis is a progressive condition requiring careful orthopaedic monitoring. Early diagnosis, structured conservative care, and timely surgical intervention when indicated are essential to prevent long-term disability and preserve neurological function.