Cervical Spine Problems Flashcards
what is cervical spine spondylosis and what does it lead to
degeneration of intervertebral discs
this can lead to increased loading and accelerated OA of facet joints
what are symptoms of cervical spondylosis
slow onset stiffness and pain in neck which can radiate locally to shoulders and occiput
how is cervical spondylosis treated
physiotherapy and analgesics
what is a complication of cervical spondylosis
osteophytes can also impinge on existing nerve roots, resulting in radiculopathy involving the upper limb dermatomes and myotomes
what is a cervical disc prolapse
acute and degenerative disc prolapse which can produce neck pain and potentially nerve root compression
what are symptoms of cervical disc prolapse
shooting neuralgic pain down dermatomal distribution
weakness and loss of reflexes
what nerve root is normally involved in cervical disc prolapse
the lower nerve root ie C7 for C6/7 disc
what can a large central cervical disc prolapse do
compress spinal cord leading to the myelopathy with upper motor neurone symptoms and signs
how is cervical disc prolapse diagnosed
clinical findings and MRI
why might doing MRI in cervical disc prolapse not be great
high rates of false positives or incidental findings
clinical findings should correlate with MRI findings before contemplating surgery
how is cervical disc prolapse treated
conservative management
if doesn’t work - discectomy may be considered
which two groups of people get cervical spine instability
down syndrome
rheumatoid arthritis
what instability are down syndrome kids at risk of getting
atlanto-axial (C1/C2) instability with subluxation potentially causing spinal cord compression
how is instability investigated in down syndrome kids
screening with flexion-extension xrays will demonstrate abnormal motion (high antalo-dens interval)
how is instability treated in down syndrome kids
minor = these children should be prevented from high impact sport
severe instability / abnormal neurology = surgical stabilisation
