L7: Spondylosis

Question 1

Def of Spondylosis

Answer 1

• A chronic degenerative changes of several discs with secondary osteoarthritis of spines, due to aging process.

Question 1

Site of Spondylosis

Answer 1

• It may be generalized but it is commoner in cervical & lumbar regions (the most mobile parts of the spine).

Question 2

Etiology of Spondylosis

Answer 2

1. Aging: degenerative changes of the discs d2 aging process (more in middle & old age).
2. Trauma or strain (males > females).

Question 3

Site of Cervical Spondylosis

Answer 3

Equal frequency at all levels Between C2 & C7 vertebrae & May involve 1 or more

Question 4

Pathological Changes in Cervical Spondylosis

• Discs

Answer 4

• Acute or Gradual Disc Protrusion
• Posteromedial Protrusion hitting the cord
• Posterolateral Protrusion hitting cord & Roots
• Lateral Protrusion hitting Roots

Question 5

Pathological Changes in Cervical Spondylosis

• Vertebrae

Answer 5

• Thickening of Vertebral Margins (Marginal Scerosis)
• New Bone Formation (Osteophytes)
• Narrowing of Intervertebral Foramen

Due to collapse & Loss of Function of DIscs & Increased Strain

Question 6

Pathological Changes in Cervical Spondylosis

• Roots

Answer 6

While Passing in the intervertebral Foramen

• Damaged By Disc protrusion or osteophytes —-> Irritation with Fibrosis —-> Constriction & Ischemia & Degeneration

Question 7

Pathological Changes in Cervical Spondylosis

• Spinal Cord

Answer 7

• Direct Compression by Disc & osteophytes

OR

• Interference with its Blood Supply (Anterior Spinal Artery “Spinal Canal” or Radicular Artery “Inter Vertebra foramen”) by Disc & osteophytes

Question 8

CP of Cervical Spondylosis

• Sensory Manifestations

Answer 8

• Radicular Sensory Manifestations
• Cord Sensory Manifestations

Question 9

CP of Cervical Spondylosis

• Radicular Symptoms (Brachialgia)

Answer 9

Question 10

CP of Cervical Spondylosis

• Neck Pain

Answer 10

Recurrent attacks of pain & stiffness of neck → Suddenly occur only vert. border of scapula & down the UL

Question 11

CP of Cervical Spondylosis

• Distribution

Answer 11

Radicular

Question 12

CP of Cervical Spondylosis

• Conused With?

Answer 12

may be confused with coronary artery dis.

Question 13

CP of Cervical Spondylosis

• Acroparasethia

Answer 13

• Burning and tingling sensation of some or All fingers, unilateral or bilateral tendency to become worse at night (d2 loss of muscle tone of cervical muscles & venous stagnation)

Question 14

CP of Cervical Spondylosis

• Motor

Answer 14

Due to Anterior root compression

Question 15

CP of Cervical Spondylosis

• Cord manifestations

Answer 15

• Pyramidal T. lesion.
• Spinothalamic Tract
• Post Column

Question 16

CP of Cervical Spondylosis

• Brainstem Manifestations

Answer 16

Due to pressure on vertebral artery by osteophytes & osteo-arthritic changes while passing upwards through the transverse foramen of cervical vertebra

• TIAs of vertebrobasilar system presented as paroxysmal attacks of vertigo precipitated by neck movements.

Question 17

Dx for Cervical Spondylosis

• Examination

Answer 17

A. Limitation of active & passive neck movement.

B. Lhermit’s sign (while shaving, barber, chair sign).

Question 18

Dx for Cervical Spondylosis

• X-Ray

Answer 18

A. Narrow disc space.

B. Marginal sclerosis.

C. Osteophyte formation.

D. Loss of normal cervical lordosis.

E. In oblique view → narrow I. Vert. F., may osteophytes project into them.

Question 19

Dx for Cervical Spondylosis

• Myelogram

Answer 19

Several anterior indentation of myodil column opposite disc spaces

Question 20

Dx for Cervical Spondylosis

• MRI

Answer 20

Preferred than CT in CX region