A incidência da espondilose cervical varia com a idade. Estudos de ressonância nuclear magnética (RNM) de base populacional mostram que quase 100% dos adultos com idade >40 anos têm degeneração grave de pelo menos 1 nível cervical (normalmente, C5/6).[1]Matsumoto M, Fujimura Y, Suzuki N, et al. MRI of cervical intervertebral discs in asymptomatic subjects. J Bone Joint Surg Br. 1998 Jan;80(1):19-24.
https://online.boneandjoint.org.uk/doi/pdf/10.1302/0301-620X.80B1.0800019
http://www.ncbi.nlm.nih.gov/pubmed/9460946?tool=bestpractice.com
[2]Guzman J, Haldeman S, Carroll LJ, et al. Clinical practice implications of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders: from concepts and findings to recommendations. J Manipulative Physiol Ther. 2009 Feb;32(2 suppl):S227-43.
http://www.ncbi.nlm.nih.gov/pubmed/19251069?tool=bestpractice.com
[3]Braga-Baiak A, Shah A, Pietrobon R, et al. Intra- and inter-observer reliability of MRI examination of intervertebral disc abnormalities in patients with cervical myelopathy. Eur J Radiol. 2008 Jan;65(1):91-8.
http://www.ncbi.nlm.nih.gov/pubmed/17532165?tool=bestpractice.com
[4]Siivola SM, Levoska S, Tervonen O, et al. MRI changes of cervical spine in asymptomatic and symptomatic young adults. Eur Spine J. 2002 Aug;11(4):358-63.
http://www.ncbi.nlm.nih.gov/pubmed/12193998?tool=bestpractice.com
[5]American College of Radiology. ACR appropriateness criteria: cervical neck pain or cervical radiculopathy. 2018 [internet publication].
https://acsearch.acr.org/docs/69426/Narrative
[6]Binder AI. Neck pain. BMJ Clin Evid. 2008 [internet publication].
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2907992
http://www.ncbi.nlm.nih.gov/pubmed/19445809?tool=bestpractice.com
No entanto, apenas um subconjunto de pacientes apresenta dor cervical axial e os pacientes geralmente são assintomáticos, embora as radiografias cervicais e a RNM possam mostrar doença degenerativa grave e espontânea.[4]Siivola SM, Levoska S, Tervonen O, et al. MRI changes of cervical spine in asymptomatic and symptomatic young adults. Eur Spine J. 2002 Aug;11(4):358-63.
http://www.ncbi.nlm.nih.gov/pubmed/12193998?tool=bestpractice.com
[7]Binder AI. Cervical spondylosis and neck pain. BMJ. 2007 Mar 10;334(7592):527-31.
http://www.ncbi.nlm.nih.gov/pubmed/17347239?tool=bestpractice.com
[8]Kovalova I, Kerkovsky M, Kadanka Z, et al. Prevalence and imaging characteristics of nonmyelopathic and myelopathic spondylotic cervical cord compression. Spine (Phila Pa 1976). 2016 Dec 15;41(24):1908-16.
http://www.ncbi.nlm.nih.gov/pubmed/27509189?tool=bestpractice.com
[Figure caption and citation for the preceding image starts]: Alterações graves e de múltiplos níveis da doença degenerativa do disco, mas sem compressão significativa da medula espinhal (isto é, sem deformações ou alterações intrínsecas em T2) na ressonância nuclear magnética (RNM) cervical (T2 sagital)Dennis A. Turner, MA, MD [Citation ends].
A incidência estimada de mielopatia cervical degenerativa é de pelo menos 41 por milhão de pessoas na América do Norte.[9]Nouri A, Tetreault L, Singh A, et al. Degenerative cervical myelopathy: epidemiology, genetics, and pathogenesis. Spine (Phila Pa 1976). 2015 Jun 15;40(12):E675-93.
http://www.ncbi.nlm.nih.gov/pubmed/25839387?tool=bestpractice.com
Em um estudo, 59% dos indivíduos com >40 anos de idade apresentaram sinais de compressão da medula espinhal na RNM.[8]Kovalova I, Kerkovsky M, Kadanka Z, et al. Prevalence and imaging characteristics of nonmyelopathic and myelopathic spondylotic cervical cord compression. Spine (Phila Pa 1976). 2016 Dec 15;41(24):1908-16.
http://www.ncbi.nlm.nih.gov/pubmed/27509189?tool=bestpractice.com
No entanto, apenas 1% a 2% dos pacientes com espondilose cervical procedem à intervenção cirúrgica, pois tratamentos não cirúrgicos são suficientes para a maioria dos pacientes.[10]Matz PG. Does nonoperative management play a role in the treatment of cervical spondylotic myelopathy? Spine J. 2006 Nov-Dec;6(6 suppl):175S-81S.
http://www.ncbi.nlm.nih.gov/pubmed/17097536?tool=bestpractice.com
[11]Mazanec D, Reddy A. Medical management of cervical spondylosis. Neurosurgery. 2007 Jan;60(1 suppl 1):S43-50.
http://www.ncbi.nlm.nih.gov/pubmed/17204885?tool=bestpractice.com
[12]Patil PG, Turner DA, Pietrobon R. National trends in surgical procedures for degenerative cervical spine disease: 1990-2000. Neurosurgery. 2005 Oct;57(4):753-8.
http://www.ncbi.nlm.nih.gov/pubmed/16239888?tool=bestpractice.com
[13]Rao RD, Gourab K, David KS. Operative treatment of cervical spondylotic myelopathy. J Bone Surg Am. 2006 Jul;88(7):1619-40.
http://www.ncbi.nlm.nih.gov/pubmed/16818991?tool=bestpractice.com
[14]Salt E, Wright C, Kelly S, Dean A. A systematic literature review on the effectiveness of non-invasive therapy for cervicobrachial pain. Man Ther. 2011 Feb;16(1):53-65.
http://www.ncbi.nlm.nih.gov/pubmed/21075037?tool=bestpractice.com
A incidência de radiculopatia da coluna cervical variou de 0.832 a 1.79 por 1000 em uma revisão sistemática.[15]Mansfield M, Smith T, Spahr N, et al. Cervical spine radiculopathy epidemiology: a systematic review. Musculoskeletal Care. 2020 Dec;18(4):555-67.
http://www.ncbi.nlm.nih.gov/pubmed/32710604?tool=bestpractice.com