CERV. spinal canal stenosis Flashcards
1
Q
CERV spinal canal stenosis classic presentation
A
older patient with history of degeneration comes in complaining about insidious neck pain with radicular arm pain
2
Q
similar DDX’s
A
- cerv. spondylotic myelopathy
- cerv. disc herniation
- IVF stenosis
3
Q
supporting factors
A
- stiff neck
- bilateral neck pain
- restricted ROM
- pain, dysthesia and anesthesia in arms and hands
- UMN signs (brisk MSR)
4
Q
refuting factors
A
- younger patient
- traumatic onset
- unilateral pain
5
Q
relevant orthos
A
- Lhermitte’s
- Dejerine’s
- CERV. distraction
- CERV. foraminal compression
- Jackson’s
- Maximal cerv. compression
- Modified spurlings
- shoulder depression
- Bakody’s
6
Q
Referrals
A
- x-rays to check for stenosis
- if myotomes are less than 3 = neurologist
7
Q
contraindications
A
- no HVLA in area of pain
8
Q
technique
A
- diversified to patient tolerance
9
Q
care plan
A
- 2x a week for 3 weeks then progress
10
Q
recommendations
A
- posture advice
- good nutrition
11
Q
prognosis
A
- can’t improve on its own nor quickly
- focus on strengthening and preventing
