Cervical Thoracic spine clinical conditions Flashcards
What is cervical spondylosis?
Degenerative osteoarthritis
of intervertebral joints
in cervical spine
What are the intervertebral joints?
Between vertebral bodies
Between facets x2
What is compressed as a result of cervical spondylosis?
Nerve roots
Spinal cord
What does compression of the nerve roots lead to?
Radiculopathy
What is radiculopathy?
Dermatomal sensory symptoms
Myotomal motor weakness
What are some dermatomal sensory symptoms?
Paraesthesia
Pain
What does compression of the spinal cord lead to?
Myelopathy
What is myelopathy?
Global weakness
Gait dysfunction
Loss of blanace
Loss of bowel and bladder control
What are the types of C2 axis fractures?
Hangman’s fracture
Peg fracture
What part of C2 axis is fractures in a hangman’s fracture?
Pars interarticularis
on both side (polo mint principle)
What happens after hangman’s fracture?
Forward displacement of C1 and body of C2
on C3 vertebrae
What is the consequence of the displacement in a hangman’s fracture?
Transaction of cord - death
in extreme cases
What causes a hangman’s fracture?
Hyperextension of head on neck
What is a peg fracture?
Fracture at base of dens
detaching it from C2 axis
What causes a peg fracture?
Blow to back of head
e.g. falling against wall
What scans are done for a peg fracture?
Open mouth AP X-ray
MRI
Because it’s difficult to see on a lateral x-ray as it’s covered up by other structures
What is an example of a C1 atlas fracture?
Jefferson’s fracture
What part of C1 atlas is fractures in a Jefferson’s fracture?
Anterior and posterior arches of atlas
What causes a Jefferson’s fracture?
Skull is driven into it
Atlas expands radially
Breaks in two places (polo mint principle)
Give some examples of injuries that may give a Jefferson’s fracture
Diving into shallow water
Impact against roof of vehicle
What are the consequences of a Jefferson’s fracture?
Pain
No neurological symptoms
Damage to arteries at base of skull
Why are there no neurological symptoms with a Jefferson’s fracture?
Large vertebral foramen
What does damage to the arteries at the base of the skull lead to?
Secondary neurological sequelae
What are some secondary neurological sequalae?
Ataxia
Horner’s syndrome
Horner syndrome info
Damage to sympathetic trunk
Gives miosis - constricted pupil
ptosis - weak droopy eyelid
anhydrosis - decreased sweating
What is whiplash injury caused by?
Hyperextension
then hyperflexion
What is damaged in whiplash injury?
No identifiable structure is damaged
What are the symptoms of whiplash injury?
Neck pain
Why is the cervical spine prone to whiplash injury?
More mobile
lack of stability
How do patients describe a cervical prolapsed disc?
Waking up with pain
What are the causes of cervical myelopathy?
Osteoarthritis of cervical spine - osteophytes
Thickened ligamentum flavum
What are the causes of thoracic cord compression?
Fracture of vertebra, bony fragments in canal
Tumour developing in spinal canal
