Cervical Spondylosis

Question 1

Define Cervical Spondylosis?

Answer 1

Progressive degenerative process affecting the cervical vertebral bodies and intervertebral discs. and causing compression of the spinal cord and/or nerve roots

Question 2

What is the aetiology of Cervical Spondylosis?

Answer 2

Osteoarthritic degeneration of the vertebral bodies leads to the formation of osteophytes
These osteophytes protrude on to the foramina and spinal canal
This leads to compression of nerve roots (radiculopathy) and anterior spinal cord (Myelopathy)

Question 3

What is the epidemiology of Cervical Spondylosis?

Answer 3

Mean age of diagnosis = 48 yrs

More common in MALES

Question 4

What are the presenting symptoms of Cervical Spondylosis?

Answer 4

Neck pain/stiffness 
Arm pain (stabbing or dull ache)
Paraesthesia 
Weakness 
Clumsiness in the hands 
Weak and stiff legs 
Gait disturbance 
Atypical chest pain 
Breast pain 
Pain in the face

Question 5

What are the signs of Cervical Spondylosis on ARMS?

Answer 5

Atrophy of the forearm and hand muscles
Segmental muscle weakness in a nerve root distribution (e.g. C5 leads to shoulder abduction and elbow flexion weakness)
Hyporeflexia
Sensory loss (mainly pain and temperature)
Pseudoathetosis (writhing finger movements when hands are outstretched, fingers spread and eyes closed)

Question 6

When do we see signs of Cervical Spondylosis on the legs?

Answer 6

If cervical cord compression

Question 7

What are the signs of Cervical Spondylosis on the legs?

Answer 7

Increased tone 
Weakness 
Hyper-reflexia 
Extensor plantar response 
Reduced vibration and joint position sense

Question 8

What is the main other sign of Cervical Spondylosis?

Answer 8

Lhermitte’s Sign

Question 9

What is Lhermitte’s Sign?

Answer 9

Neck flexion causes crepitus (grating sound) and/or paresthesia down the spine

Question 10

What investigation do you do for Cervical Spondylosis?

Answer 10

Spinal X-Ray (lateral)