Aging Cervical Spine

Question 1

When do changes to IV disc begin?

Answer 1

As young as 10-16 years of age

Question 2

What percentage of asymptomatic people had degenerative MRI findings at a mean age of 48?

Answer 2

90%

Question 3

Early spondylosis most commonly affects what levels of the C-spine?

Answer 3

C5-C7

Question 4

Early spondylosis symptoms may include…

Answer 4

Localized neck pain
Discogenic symptoms
Facet arthropathy
Cervical Radiculopathy

Question 5

Agg factors for early spondylosis (1)

Answer 5

AROM usually painful when rotation and side bending towards painful side
Flexion and or extension may be painful

Question 6

Agg factors for early spondylosis (2)

Answer 6

Use of ipsilateral shoulder may be limited and reproduce pain

Question 7

Agg factors for early spondylosis (3)

Answer 7

Sustained neck postures/positions may elicit latent arm symptoms (neural irritation)

Question 8

Early spondylosis 24 hour symptoms

Answer 8

Morning stiffness which improves through the day but may worsen with prolonged positions

Question 9

History/progression of symptoms (1)

Answer 9

Gradual onset of symptom in the cervical spine and/or arm which increases in frequency and severity with time

Question 10

History/progression of symptoms (2)

Answer 10

Slight trauma or stress to the C/S may trigger symptom development

Question 11

History/progression of symptoms (3)

Answer 11

Typically present with unilateral pain distribution

Question 12

Objective exam findings of early spondylosis (1)

Answer 12

Decreased sagittal plane motion: Extension more pain and limited than flexion

Question 13

Objective exam findings of early spondylosis (2)

Answer 13

Decreased frontal and transverse plane motion: Side-bend and rotation to the same side

Question 14

Why does cervical extension result in more canal stenosis than flexion?

Answer 14

Because of narrowing of the canal and ligamentum flavum redistribution in extension

Question 15

What population is stenosis most commonly seen?

Answer 15

Patients over the age of 50

Question 16

What are 3 different causes of stenosis?

Answer 16

Degenerative
Congenital
Traumatic

Question 17

What can the body chart for cervical stenosis look like?

Answer 17

Neck pain with or without distal symptoms

Question 18

What aggs can cervical stenosis bring on?

Answer 18

Looking up, sustained extension posture; similar to spondylosis

Question 19

What does the 24 hour pattern look like for those with C stenosis?

Answer 19

Sleep may be affected (prolonged extension or lateral flexion); AM/PM may vary

Question 20

History for c stenosis (1)

Answer 20

Insidious onset in degenerative patient cases. May have history of trauma.

Question 21

History for c stenosis (2)

Answer 21

Chronic neck symptoms, slow progression

Question 22

History for c stenosis (3)

Answer 22

Episodes of worsening symptoms with periods of relief

Question 23

Objective exam presentation for c stenosis (1)

Answer 23

Cervical motion loss similar to spondylosis

Question 24

Objective exam presentation (2)

Answer 24

Patient may demonstrate upper extremity symptoms