Aging Cervical Spine Flashcards
When do changes to IV disc begin?
As young as 10-16 years of age
What percentage of asymptomatic people had degenerative MRI findings at a mean age of 48?
90%
Early spondylosis most commonly affects what levels of the C-spine?
C5-C7
Early spondylosis symptoms may include…
Localized neck pain
Discogenic symptoms
Facet arthropathy
Cervical Radiculopathy
Agg factors for early spondylosis (1)
AROM usually painful when rotation and side bending towards painful side
Flexion and or extension may be painful
Agg factors for early spondylosis (2)
Use of ipsilateral shoulder may be limited and reproduce pain
Agg factors for early spondylosis (3)
Sustained neck postures/positions may elicit latent arm symptoms (neural irritation)
Early spondylosis 24 hour symptoms
Morning stiffness which improves through the day but may worsen with prolonged positions
History/progression of symptoms (1)
Gradual onset of symptom in the cervical spine and/or arm which increases in frequency and severity with time
History/progression of symptoms (2)
Slight trauma or stress to the C/S may trigger symptom development
History/progression of symptoms (3)
Typically present with unilateral pain distribution
Objective exam findings of early spondylosis (1)
Decreased sagittal plane motion: Extension more pain and limited than flexion
Objective exam findings of early spondylosis (2)
Decreased frontal and transverse plane motion: Side-bend and rotation to the same side
Why does cervical extension result in more canal stenosis than flexion?
Because of narrowing of the canal and ligamentum flavum redistribution in extension
What population is stenosis most commonly seen?
Patients over the age of 50
What are 3 different causes of stenosis?
Degenerative
Congenital
Traumatic
What can the body chart for cervical stenosis look like?
Neck pain with or without distal symptoms
What aggs can cervical stenosis bring on?
Looking up, sustained extension posture; similar to spondylosis
What does the 24 hour pattern look like for those with C stenosis?
Sleep may be affected (prolonged extension or lateral flexion); AM/PM may vary
History for c stenosis (1)
Insidious onset in degenerative patient cases. May have history of trauma.
History for c stenosis (2)
Chronic neck symptoms, slow progression
History for c stenosis (3)
Episodes of worsening symptoms with periods of relief
Objective exam presentation for c stenosis (1)
Cervical motion loss similar to spondylosis
Objective exam presentation (2)
Patient may demonstrate upper extremity symptoms
