Stiff neck in this 70 year old male

This man’s chief complaint was neck stiffness and some pain, but it was not acute, nor severe. He also has an obvious kyphotic deformity of his upper back, though I’ve seen much worse.

When it comes to treatment, I typically use spinal decompression, especially on older necks because they have a lifetime of compressive changes. But this is an example of something else, called heterotopic ossification.. Dr. Castanet will point out that his anterior longitudinal ligament is ossified, and his spinal discs are spared from significant compressive changes. Yes, he probably has some mild degenative compression, but the predominant x-ray finding is the calcification of his ligaments, specifically his ALL, with sparing of his discs.

Stiff neck in this 70 year old male

Also of note, is the osteopenic appearance of his vertebrae, another common finding in such pathology. This gentleman has not had a bone density study because there is no indication to do so. He is a large, older male so he doesn’t have any risk factors that would indicate need. And, even with the present appearance of his neck, I don’t see a pressing need for that. Whether this x-ray appearance would correlate with any risk of generalized osteoporosis, and risk of fracture is speculative, and x-rays are not always reliable for such an assessment.

Dr. Castanet will also revisit his theme of pillows as causative in kyphotic deformities. I think it is harder to rationally argue that pillows have no such influence, than to argue that they do. Of course, that doesn’t prove my hypothesis, but I have personal anecdotal reasons, as cited in a previous video, that convinces me that doffing the pillow is the more prudent behavior. Until we know, like so much in medicine, I suggest you try it yourself.

If I can help you with your neck or back problem, please call me at 404-558-4015.