Ch. 14 - Cervical disc disease and cervical spondylosis Flashcards
predominant sx of cervical spine disorders
neck pain and arm symptoms
cause of cervical spine disorders
degenerative changes in vertebral column = cervical disc disease and cervical spondylosis
most common level of cervical disc herniation
C6/7 > C5/6 (fulcrum of head/spine), otherwise uncommon
direction of disc herniation in cervical spine and implication
posterolaterally because PLL prevents direct posterior herniation ==> nerve root entrapment at the level of the spinal nerve (ie C5/6 prolapse = C6 nerve entrapment)
presentation of cervical disc herniation
“deep achy” neck and arm pain and neurologic manifestations of cervical nerve root compression (radiculopathy)
upper extremity dermatome
C5 - upper arm and forearm
C6 - shooter
C7 - middle finger
C8 - 4th/5th digits
upper extremity myotomes
shoulder: abduction C5, adduction: C6-8
elbow: flexion C5/6, extension: C7/8
Forearm: supinate C6, pronate C7/8
Wrist: flexion C6-8, extension C7/8
Intrinsic hands: C8/T1
Characteristic C6/7 disc prolapse
C7 nerve root compression = weakness with elbow extension, absent triceps jerk, numbness/tingling middle finger
UE reflexes
biceps - C5, brachioradialis - C6, triceps - C7
Characteristics of C5/6 disc prolapse
C6 nerve root compression = absent brachioradialis reflex, numbness/tingling of C6 shooter
Characteristics of C7/T1 disc prolapse
C8 nerve root compression = weakness in long flexors, triceps, finger extensors, intrinsic hand muscles, decreased sensation in 4th/5th digits
ddx disc prolapse
spinal tumor, thoracic outlet syndrome, pancoast’s tumor, peripheral nerve entrapment
disc prolapse management
conservative - bed rest, cervical collar, NSAIDs, muscle relaxants
indications for surgical intervention of disc prolapse
pain > 10 days w/o relief, significant weakness, e/o myelopathy
Dx cervical disc prolapse with…
MRI
