CERV. spondylotic myelopathy Flashcards
1
Q
CERV. spondylotic myelopathy classic presentation
A
- male/asian older than 55 with hisorty of cerv. degeneration
- insidous complaint of gait/coordination changes, clumsiness in hands, pain in shoulders and arms
2
Q
similar DDX’s
A
- CERV. spondylosis
- CERV. spinal canal stenosis
- CERV. ivf stenosis
3
Q
supporting factors
A
- GAIT INSTABILITY
- upper extremity numbness
- loss of fine hand motor control
- HYPERREFLEXIA
- neck stiffness
- UMN or LMN changes in upper and lower extremities
- bilateral glove stocking
4
Q
refuting factors
A
- young age
- traumatic origin
- sudden onset
- no gait abnormalities
5
Q
relevant orthos
A
- Lhermitte’s sign
- CERV. distraction
6
Q
physical findings
A
- glove and stocking (pcml loss)
- extensor babinski’s
7
Q
referrals
A
- neurologist for diagnosis
- orthopaedic specialist for decompression surgery
- MRI to check canal diameter
8
Q
contraindications
A
- no adjusting CERV. spine
9
Q
technique
A
- activator in neck
10
Q
care plan
A
- 3 x week for 4 weeks
11
Q
recommendations
A
- cerv. traction
- skull traction
- cerv. immobilisation
- surgery
12
Q
prognosis
A
- 40% stabilize
- 40% deteriorate without treatment
- 18% improve spontaneously
