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A: MSK UQ > Lecutre 3: C Spine Interventions > Flashcards

Lecutre 3: C Spine Interventions Flashcards

1
Q

What are the 2 main objectives to cervical spine interventions

A

Reverse dysfunctions

Prevent recurrence/transition to chronic SYMTOMS

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2
Q

What do u want to encourage in the acute phase goals for c spine

A

Pt to perfomr ADLS as tolerated

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3
Q

How should the head Reamin during sleeping in the acute phase goals of C spine

A

Neutral in SL or supine

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4
Q

In the acute phase goasl for c spine do we want to rest

A

NO NO NO unless symptoms are very severe

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5
Q

Is early motion within tolerated ROM encourage for acute phase goasl

A

Yes

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6
Q

What does research support in the acute phase interventions in the c spine q

A

Use of manual therapy techniques early

  • t spine more stiff then C spine so if improving t spine mobility can decreased stress on c spine
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7
Q

What is a great intial choice for TX for the acute phase interventions

A

Walking bc less stress on the tissues

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8
Q

Are the use of passive intervention or active interventions more common w c spine

A

Active

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9
Q

Do cervical collars help with C spine

A

No a lot of studies suggest it delays recovering

Buttt it can be used to support head and neck if pt has SEVERE capsular restriction

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10
Q

What are the functions of the Ccervical collars

A

• Maintain erect c-spine
• Reminds pt neck is injured
• Allows pt to rest chin during
activity, thereby offsetting weight
of head
• Allows pt to perform cervical
rotation while weight of head is
offset

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11
Q

What phase should u achieve significant decrease or complete resoluation of pt pain

A

Sub acute

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12
Q

How much ROM is restored in the sub acute phase

A

Full and pain free

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13
Q

What are teh subacute phase goals for c spine

A
  • decrease pain
  • full pain free ROM
  • postural stabilization re traiing of spine
  • full integration of entire upper and lower kinetic chains
  • ergonomics changes to workspace to decrease stress
  • overall strength and CV fitness training
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14
Q

what is critical to prevent in the subacute phase

A

Prevention chronicity and distability

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15
Q

What is vital for successful outcomes in the sub acute phase

A

Correctly categorizing and then re categorizing

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16
Q

What is the chronic phase approach

A
  • max function
  • pay attention to yellow flags
  • use multi modal approach tailored to pt needs
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17
Q

What are common S/S for neck pain w mobility deficits bucket

A
  • central or unilateral neck pain
  • limitation in neck ROM that consistently reproduces SYMTOMS **
  • associated shoulder girdle or UE pain may be present
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18
Q

What are the expected exam findings for neck pain w mobility deficits bucket (5)

A
  • Limited cervical ROM
  • Neck pain reproduced at end ranges of AROM
    and PROM
  • Restricted segmental cervical and thoracic
    mobility
  • Neck and referred pain reproduced w/
    provocation of involved cervical or upper
    thoracic segments
  • Deficits in cervico-scapulo-thoracic strength and
    motor control`
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19
Q

For patient w acute neck pain w mobility deficits what should PT provide

A

Thoracic manip
Neck ROM exercise
ST and UE strengthening

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20
Q

For patient w subacute neck pain w mobility deficits what should PT provide

A

Neck anf shoulder girdle endurance exercises

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21
Q

For patient w chronic neck pain w mobility deficits what should PT provide

A

Thoracic manip and cervical manip

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22
Q

What phase does PT use dry needling , laser and traction to help w neck pain w mobility deficits

A

Chronic phase

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23
Q

• MOI linked to trauma or whiplash; OR general
hypermobility (gradual onset, no clear MOI)
• Associated (referred) shoulder girdle or UE pain
• Associated varied non-specific concussive S&S
• Dizziness/nausea
• HA, concentration or memory deficits
• Confusion
• Hypersensitivity to mechanical, thermal,
acoustic, odor or light stimuli
• Heightened affective distress

This sounds like common s/s for which neck bucket

A

Neck pain w movement coordination impairments (WASD)

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24
Q

What is a common MOI for neck pain w movement coordination impairment

A

Linked to trauma or whiplash or general hypermobility

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25
Q

What 3 test are postivie w neck pain w movement coordination impairments

A
  • (+) Cranial Cervical Flexion Test
  • (+) Neck Flexor Muscle Endurance Test
  • (+) pressure algometry
26
Q

What are 5 most expected exam findings along w the 3 positive test for neck pain w movement coordination impairments

A
  • Strength and endurance deficits in neck mm.
  • Neck pain w/ mid range motion that worsens w/ end
    range positions
  • Point tenderness, may include trigger points
  • Sensorimotor impairments may include altered mm
    activation patterns, proprioceptive deficits, postural
    balance or control
  • Neck pain and referred pain reproduced by provocation
    of involved segments`
27
Q

What pt education is provided w Neck Pain w/ Movement Coordination Impairments (WAD)

A

Stay active !!!! Should be goood in 1st 2-3 months

28
Q

What exercises should u start with for Neck Pain w/ Movement Coordination Impairments (WAD)

A

Cervical isometrics —> scap stabilizer —> cervical spine extensors —> general conditioning —> pt education

29
Q

If a patient is experiencing delayed/prolonged recovery for Neck Pain w/ Movement
Coordination Impairments (WAD) what should u do

A

Include multi modal approach including early pain science education

30
Q

In the acute phase of Neck Pain w/ Movement Coordination Impairments (WAD) what should the clinicians provide

A
  • retunr to normal
  • dont use cervical color
  • recovery in 2-3 months
  • provide multimodal intervention approach
31
Q

What is common signs and symptoms for neck pain w HA (Cervicogenic)

A
  • Non-continuous, unilateral neck pain
    and associated (referred) HA
  • HA precipitated or aggravated by
    neck movements or sustained
    positions/postures
32
Q

What test will be positive for Neck Pain w/ Headaches (Cervicogenic)

A

Cervical flexion rotation test ( testing AA joint)

33
Q

What are 3 expected exam finding with Neck Pain w/ Headaches (Cervicogenic)

A
    • HA reproduced w/ provocation of
      involved upper cervical segments
  • Limited cervical ROM and joint
    mobility
  • Strength, endurance and motor
    control deficits in neck mm
34
Q

In what phase of Neck Pain w/ HAs is cervical manipulation and mobilization recommended

35
Q

In what phase of Neck Pain w/ HAs should PT provide cervical or CT manipulation or mobilization combined w shoulder girdle and neck strtching , strength ting and endurance

36
Q

When should pt recommend self SNAGS to AA joint for Neck Pain w/ HAs

37
Q

What should pt recommend during the acute phase of Neck Pain w/ HAs

A

Active mobility exercises

38
Q

Who do Cervicogenic HA often occur in

A

Pts w deficits in OA , AA and C2-C3 mobility

39
Q

If a patient comes in and complains of bilateral HA what do we automatically think of

A

Tension bc it is the only bilateral HA

40
Q

What is symptoms with Cervicogenic HA

A

Unilateral
Decreased vertical ROM from tissues innervated by C1-C3

41
Q

How do u treat Cervicogenic HA

A

Posture
MT
Exercise
Analgesics
NSAIDS

42
Q

If a patient comes in w neck pain w radiating pain in invovled UE and UE dermatomyositis parasthesia or numbness or myotomal mm weakness what bucket for we thinking

A

Neck pain w radiating pain

43
Q

What is most likely (+) for neck pain w radiating pain

A

CPR (at least 3 have to be positive)

(+) ULTT
Neck pain reproduced or delivered w cervical ROM
- (+) spurling
- (+) distraction

45
Q

At what phase is laser therapy recommend for neck pain w radiating pain

46
Q

What should a PT do for chronic phase neck pain w radiating pain

A
  • mechanical traction
  • strtching
  • strengthening
  • mobs
47
Q

Do u do thrust or non thrust in the C spine for manual therapy? What about T spine

A

Both

Just thrust in T spine

48
Q

What are teh CPR variables that would identify a pt who would benefit from T spine thrust (6)

A
  • Symptoms <30 days
  • No symptoms distal to
    shoulder
  • Looking up aggravate
    symptoms
  • FABQ physical activity score
    <12
  • Diminished upper thoracic
    spine kyphosis
  • Cervical extension ROM
    <30º

Only 3 or more out of the 6 need to be present to work

50
Q

What is the sequencing of manual therapy interventions for neck pain

A
  1. Rule out t spine hypomobility
  2. Start lower cervical / CT junction and work superiorly
51
Q

What is the RX for Cervicogenic HA short and long term

A

Manual therapt short term

Neck exercises in long term

52
Q

How do you joint mob C2-C3 , C2 , and C1 for HA

A

• Rx C2-3 in neutral
• Rx C2 under C1 in rotation
• Rx C1 under occiput

53
Q

How does traction + nerve glides help

A

Decrease neck and arm pian and increase function

54
Q

How does manual therapy + exercise help

A

Decrease neck and arm pian and increase function

55
Q

When would u do a surgialca intervention in the C spine (5)

A
  • fx
  • signifcant weakness
  • progressive neurological deficits
  • severe , unremitting pain
  • persistent radicualr pian
56
Q

What are common surgical procedures

A

• Anterior cervical
discectomy and fusion
• Anterior corpectomy and
fusion
• Laminectomy
• Laminoplasty

57
Q

What is the most common sx for c spine

A

• Anterior cervical
discectomy and fusion

58
Q

How do they do an anterior corpectomy and fusion

A
  1. Diseased/damaged bone removed
  2. Bone graft placed
  3. Fusion using metal plate and screws`
59
Q

What is a laminectomy indicate for

A
  • Spinal stenosis
  • Multi level DDD
    w/ ant spinal cord
    compression
60
Q

What is a laminoplasty indicate for

A

Multi level spondylotic myelopathy

61
Q

What is the goals for a laminoplasty

A

X * Eliminate nerve compression
lesion
* Preserves segmental spine
motion

A: MSK UQ (20 decks)

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