1 Lower C Spine Syndromes Flashcards
What are two common syndroms in the lower C spine?
Cervical Spondylosis
Cervical IVD
What is Cervical Spondylosis?
Age related degeneratuve changes at IV disc then involve other tissues
- (typically age 40-50)
- Articular cartilage of apophyseal joint
- bones of C spine
- Unciform processes and joints
What are the 4 clinical presentaion groups of cervical spondylosis?
- Neck pain
- Neck pain with proximal refferal (disc or facet)
- Radicular pain (nerve root)
- Meylopathy (spinal cord)
What is the pathological process for cervical spondylosis?
Degenerative changes in IV disc
- Decreased hydration and water binding capacity of nucleus pulposus
- Decreased intradiscal pressure leads to buckling of annular rings, fibrillation and weakening
What are the symptoms of Cervical Spondylosis?
- Cause by narrowing or encourachment of
- Vertebral canal - spinal cord signs
- Intervertebral foramen - nerve root signs
Possible ostephyte on anterior C3 body can compress esophagus
How are the segmental levels of the C spine with Cervical Spondylosis?
- mainly lower C spine
- More frequently in C5/6, C6/7, then C3/4, C4/5
- Degenerative changes in C2/3 Rare
- C disc protrusions occur laterally and can catch nerve root
What is the history of a C spondylosis patient?
Older patient (develop degenerative changes
Past episodes of the same pain
What is the subjective presentation for a C spondylosis patient?
- Pain in lower C spine, or radiating down into both UE
- If advanced - radiculopathy (nerve root or spinal cord - myelopathy)
- Siffness is common
- movement and posture as aggs
What are the objective findings of C spondylosis?
Lower C spine - flex/ext limited movements
Flexion more painful bc of disc
Quadrant may be posituve for reffered pain (radiculopathy)
Upper limb tension test
X rays shows degenerative changes
What is the treatment for C spondylosis?
Dependant on grouping
Modalites for pain releif (US, Heat)
Mobilization for stuff segments
Exercises and posture correction to control/prevent exacerbation
What is cervical IVD syndome?
- Metabolic changes from aging and truma that lead to degeneration of disc
- NON-specific pain
- Symptoms in neck - may radiate to arm, shoulder, scap
- Syndroms from lwer C spine
- Self limiting disorder UNDER 30 years old
SPONTANEOUSLY RESOLVES
What ar the Subgroups of cervical IVD syndrome?
- Postural
- Dysfunction
- Derangement
What is Brachial Neuralgia?
- Can come from Cervical IVD syndrome (untreated)
- Cervical radiculopathy
- Pain in distribution of specfiic nerve root = compressive pathology
- short lived (16 weeks - natural resplution, some residual weakness)
- proceeded by eisodic neck pain
- Posture ( slight flecion and lateral flexion away from affected side)
- Inolves C5-C7
What are the frequencies for Brachial Neuralgia for each segment? (which as the most and least occurance)
- MOST - C5/6 (C6 ROOT) (radial side of arm and thumb, index finger - weak biceps and brachialis
- C6-7: (C7 ROOT) Posteriolateral part of shoudler and upper arm, lower arm 2 3 4th finger. weak triceps, pronator teresm and thenar muscles
- C7 - T1: (C8 ROOT) - ulnar side of arm 4th and 5th finger, motor deficit of finger flexors, interosseous and hypothenar muscles
- LEAST -C4/5 (C5 ROOT) - shoulder to proximal half of upper arm
What is the incidence and recovery for Brachial Neuralgia?
- Incidence: heavy lifing frequent, smoking, vibrating equipment, riding in cars
- Recory: depends on radiating symptoms - Centralization
