Cervical spondylosis Flashcards
Define cervical spondylosis
Progressive degenerative process affecting cervical vertebral bodies & intervertebral discs, & causing compression of spinal cord &/or nerve roots
Aetiology of cervical spondylosis
3
Osteoarthritic degeneration of vertebral bodies —> formation of osteophytes
These osteophytes protrude on to foramina & spinal canal
Leads to compression of:
- nerve roots: radiculopathy
- anterior spinal cord: myelopathy
Epidemiology of cervical spondylosis
age, gender
Mean age at diagnosis = 48 yrs
More common in MALES
Presenting symptoms of cervical spondylosis
10
Neck pain/stiffness Arm pain (stabbing or dull ache) Parasthesia Weakness Clumsiness in hands Weak & stiff legs Gait disturbance Atypical chest pain Breast pain Pain in face
Signs of cervical spondylosis on physical examination - ARMS
5
Atrophy of forearm & hand muscles Segmental muscle weakness in a nerve root distribution Hyporeflexia Sensory loss (mainly pain & temperature) Pseudoathetosis
Signs of cervical spondylosis on physical examination - LEGS
general +5
Increased tone Weakness Hyperreflexia Extensor plantar response Reduced vibration & joint position sense
Signs of cervical spondylosis on physical examination - Lhermitte’s sign
Neck flexion causes crepitus (grating sound) &/or parasthesia down the spine
Investigations for cervical spondylosis
3 types
Spinal xray (lateral)
MRI
Needle electromyography (EMG)
Investigations for cervical spondylosis - spinal xray
2
Can detect osteoarthritic change
Rarely diagnostic if non traumatic
Investigations for cervical spondylosis - MRI
2
Allows assessment of root & cord compression
Helps exclude spinal cord tumours & nerve root infiltration by granulomatous tissue
Define pseudoathetosis
writhing finger movements when hands are outstretches, fingers spread & eyes closed
