Cx Spine Disorders

Question 1

Disc degeneration stages

Answer 1

1)normal
2)degeneration/herniation
3)prolapse
4)extrusion
5)sequestration

Common clinical feats:
Sudden onset of severe neck pain frequently in the midline. Later in time will present with an onset of radicular pain and their logical signs and symptoms.

C3, c4 roots associated with predominantly neck and head symptoms.

C5-T1( brachial plexus roots) associated with predominantly upper limb symptoms. Usually unilateral can be bilateral if the protrusion is central or large.

Reduced range of motion and paravertebral muscle spasms ( antalgic posture, and forward flexion and lateral bending)

Aggravated by: dejerines triad- valsalvad maneuver, coughing, and sneezing.

Relieved by : immobilization, changing positions, frequently and strong analgesics.

Question 2

Causes for referral?

Answer 2

-Evidence of cord compression- myelopathy.
-Acute patient with persistent, severe radicular pain, and neurological signs.
-patient not responding to treatment or worsening.
-Also if findings in imaging do not correspond with the method of treatment.

Question 3

DDD

Answer 3

Very common
M=F, >35
-Cell mediated response to progressive structural failure due to aging and other environmental factors such as abnormal mechanical stress.
-initiated by injury
-osteophytes form as a result.

Tests used:
Distraction
Spurlings
Jackson’s

Question 4

DJD

Answer 4

4 major symptoms it presents:
-Headaches (cervicogenic)
•cx and trigeminal effects three upper Cx-> may refer to head and face.
•usually these headaches are frequent. Aggravated by neck movements and sustained postures.
-Generalized neck and shoulder pain.
•insidious onset of neck pain and stiffness frequently associated with headaches.
- Radiculopathies
• referred pain spreading over shoulder, possibly upper arm. With no neurological signs.
• sharp, shooting pain from the nerve compression and irritation.

Tests:
All IVF compression

Question 5

Cx spondylosis

Answer 5

Cervical spondylotic myelopathy:
Chronic disc degeneration with associated osteophytes is the common us cause of spinal cord dysfunction in >55 yo

S/s:
Symptoms develop slowly over period of months/years .
Previous history of intermittent neck, pain, and radicular pain .
-Tingling sensations in both hands and weakness and clumsiness, wasting of muscles=LMNL
-Signs such as spasticity hyperreflexia clonus=UMNL

Question 6

Cx strain and sprain

Answer 6

Presents with pain stiffness and restricted range of movement
-A/PROM painful
-No neurological signs and symptoms
-Tenderness on palpation

Question 7

Cx posterior facet syndrome

Answer 7

Deep, aching, pain and tenderness
Non-dermatomal, non-cutaneous sensory distribution or referred pain .
Richly innervated by zygapophyseal with mechanoreceptors

Question 8

Reflex Sympathetic Dystrophy

Answer 8

Shoulder hand syndrome.

-20% associated with cervical spondylosis.
-M<F
-50-70 or >30

Causes:
Injury to a specific nerves or C and Adelta fibers that innervate the tissue.
It is a progressive illness that spreads with time, and may target the entire body
Presentations:
Limited shoulder movement
Diffuse hand pain
Pitting, edema of hand
Warm, moist, shiny skin of hand
5 Major futures:
Pain
Swelling
Autonomic dysregulation
Movement disorders
Atrophy
Dystrophy