Cervical Spondylotic Myeolpathy Flashcards

1
Q

Spondylosis

A

Progressive degenerative process affecting the cervical bodies and IVDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Myelopathy

A

Caused by compression of the SC due to narrowing (stenosis) of central SC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Cervical spondylotic myeolpathy

A

most common cause of myelopathy in adults over 55 y.o.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Cervical spondylosis

A

disc herniation, osteophyte formation, hypertrophy of posterior longitudinal ligament and ligamenta flava

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Injury to anterior horn cells causes what deficit

A

LMN deficits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Pathophysiology

A
  1. mechanical compression of neural elements
  2. SC ischemia due to compression of the arterial and/or venous blood supply to the cord
  3. flexion and extension of neck may exacerbate compression
  4. Radiculomyelopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Clinical Presentation

A
  1. Pain, neck creptius
  2. Numbness/paresthesia in arms - dermatomal pattern
  3. Gait disturbance (eary symptom) - spastic scissoring quality
  4. Sensory disturbance - reduced joint position/vibratory sense, loss of pain
  5. UMN findings in lower extremities - inc. tone/reflex, weakness, + Babinski
  6. LMN finding in myotomal distribution of arms/hands - weakness, atrophy, suppressed reflexes
  7. Bladder dysfunction
  8. Lhermitte’s sign
  9. Acute presentation - due to fall, whiplash injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

C5 region of pain

A

Neck, shoulder, scapula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

C5 region of numbness

A

Lateral arm (in distribution of axillary nerve)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

C5 weakness

A

Shoulder abduction, ER, elbow flexion, forearm supination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

C5 reflex affected

A

Biceps and brachioradialis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

C6 region of pain

A

Neck, shoulder, scapula, lateral arm, lateral forearm, lateral hand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

C6 region of numbness

A

Lateral forearm, thumb, and index finger

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

C6 weak movements

A

Shoulder abduction, ER, elbow flexion, forearm supination/pronation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

C6 reflex affected

A

Biceps and brachioradialis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

C7 region of pain

A

Neck, shoulder, middle finger, hand

17
Q

C7 region of numbness

A

Index and middle finger, palm

18
Q

C7 weak movements

A

elbow and wrist extension (radial), forearm pronation, wrist flexion

19
Q

C7 reflex affected

20
Q

C8 region of pain

A

neck, shoulder, medial forearm, fourth and fifth digits, medial hand

21
Q

C8 region of numbness

A

medial forearm, medial hand, fourth and fifth digits

22
Q

C8 weak movements

A

Finger extension, wrist extension (ulnar), distal finger flexion, extenion, abduction, and adduction, distal thumb flexion

23
Q

C8 reflex affected

24
Q

T1 region of pain

A

neck, medial arm and forearm

25
T1 region of numbness
Anterior arm and medial forearm
26
T1 weak movements
thumb abduction, distal thumb flexion, finger abduction and adduction
27
T1 reflex affected
NONE
28
Diagnosis of cervical spondylotic myelopathy
MRI/CT scan | EMG - could show info regarding presence/degree of ant. horn cell or spinal nerve route damage
29
Prognosis of cervical spondylotic myelopathy
Natural history not well characterized 2. deterioration can be - Progessive - Slow and stepwise deterioration with long periods of stability - abrupt deterioration with minor neck injury
30
Treatment of cervical spondylotic myelopathy
Conservative measures 1. neck immobilization 2. Restrict high risk activities/environments 3. pain management - NSAIDS, other analgesics - muscle relaxants - Antidepressant medications
31
Treatment for acute myelopathy
1. Neurologic emergency 2. Immediate neuro-imaging 3. Prompt neurosurgical/orto consultation 4. high - dose IV corticosteroid
32
ALS but not cervical spongy myelopathy
CN involvement and tongue fasciculation.... Both have muscle weakness and hyporeflexia