Cervical Spine Flashcards
What is cervical spondylosis
basically OA of the cervical spine due to disc degeneration and increased pressure on the facet joints
presentation of cervical spondylosis
slow onset neck stiffness and pain
radiation of pain to shoulders and occiput
Tx of cervical spondylosis
analgesics
physiotherapy
What causes radiculopathy in cervical spondylosis
osteophytes impinging on nerve roots
radiculopathy definition
mechanical compression of a nerve root
symptoms of cervical disc prolapse
shooting neuralgic pain down a dermatomal distribution and weakness with loss of reflexes depending on the nerve root affected
Ix for suspected cervical disc prolapse
MRI
Tx of cervical disc prolapse
Conservative Mx - analgesia and physio
If resistant - consider discectomy
2 main causes of atraumatic cervical spine instability
Down’s syndrome
Rheumatoid arthritis
What part of the cervical spine is at risk of instability in children with Down’s syndrome
Atlanto-axial (C1/C2) instability with subluxation
How is cervical spine instability in children with Down’s syndrome detected
Screening flexion-extension xrays - demonstrate the abnormal motion
Mx of cervical spine instability in children with Down’s syndrome
Minor - prevention from taking part in high impact/contact sports
Major - surgical stabilisation if severe or presence of abnormal neurology
What part of the cervical spine is at risk of instability in patients with RA
Atlanto-axial (C1/C2) instability with subluxation
Why are patients with RA at risk of cervical spine instability
destruction of the synovial joint between the atlas and the dens and rupture of the transverse ligament
Mx of cervical spine instability in patients with RA
Minor - collar to prevent flexion
Major - surgical fusion/stabilisation
