What is chronic osteochondral bar?

Answer 1

Degenerative processes in the cervical spine can lead to osteophyte formation involving the posterolateral uncovertebral joints and along the posterior margins of the cervical vertebra, at the levels of the superior and inferior endplates. If there is associated discogenic degenerative change resulting in diffuse bulging of the intervertebral disc sandwiched between these bony osteophytes, the combination is sometimes called an osteochondral bar. The term is purely descriptive, noting the broad ridge-like shape of the process and the combination of bony and cartilaginous elements involved.

Advanced degenerative changes of the zygapophyseal and uncovertebral joints of the cervical spine are of clinical interest. They can cause narrowing of the lateral neural foramina (through which course the cervical nerve roots), the central canal (housing the thecal sac and spinal cord) and the osseous channels for the vertebral arteries, leading to possible compression and compromise of those structures. The end result could be intracranial cerebrovascular events, cervical cord myelopathic signs and symptoms and cervical radiculopathy involving the upper extremities.

The presence of these osteochondral bars alone doesn't necessarily mean the patient will suffer these clinical consequences but it should alert the physician to the risk of future potential neurologic signs and symptoms. If some of the clinical signs are suspected, electromyography can accurately diagnose nerve root compression and anterior horn cell syndromes. Sensory-evoked potentials and motor-evoked potentials can further check for cervical myelopathy. From an imaging standpoint, cervical magnetic resonance is the most accurate modality to assess the presence of cervical spondylosis and associated central cord and proximal nerve root changes.