myelopathy and radiculopathy

Question 1

how can radiculopathy and myelopathy pain occur?

Answer 1

distortion stresses in fascial attachments and muscles,

muscle fatigue causing local accumulation of metabolites,

stress in facet joint and SI joint capsules,

inflammation of facet joints,

irritation of perivascular and periostal nerves,

distortion of posterior annulus and PLL by discs

Question 2

what are forces highest on vertebral discs?

Answer 2

when sitting

Question 3

what are degenerative diseases of the spines?

Answer 3

disorders due to change in the tissues of the vertebral column which occurs to some extent In all individuals after early adult life

Question 4

what happens in ageing of the disc?

Answer 4

dehydration,

invasion of firbo cartilage by nuceleus,

loss of elasticity,

fissuring,

uniform cartilage plate

Question 5

what is radiculopathy?

Answer 5

compression/pathology of the nerve root.

Question 6

what is myelopathy

Answer 6

pathology of the spinal cord

Question 7

an annular disc rupture is symptomatic if it occurs in which direction?

Answer 7

posteriorally

Question 8

what is chronic disc disease otherwise reffered to as?

Answer 8

spondylosis

Question 9

what is chronic disc disease?

Answer 9

degenerative condition of the vertebral discs, occurs in later life, disc flattening and dehydration as well as secondary chances such as deformity (spondyloisthesis)

Question 10

what two types of cervical spondylosis can occur?

Answer 10

cervial spondylosis radiculopathy (CSR), Cervical Spondylosis Myelopathy (CSM)

Question 11

describe the natural history of cervical spondylosys radiculopathy

Answer 11

common, self limiting, not recurrent

Question 12

describe the natural history of cervical spondylosys myelopathy

Answer 12

often stabilises, some milder cases spontaneously improve, not fully explained by compression

Question 13

what are the clinical features of radiculopathy?

Answer 13

neck pain and stiffness, headaches, limb: pain, sensory loss, weakness, reflex loss

Question 14

what are the clinical features of myelopathy?

Answer 14

slow onset or sudden with trauma, upper limbs: numb, clumbsy, muscle wasting, lower limbs: stiff heavy legs, poor balance and falls

Question 15

what are five differential diagnoses of Cervical Spondylosis Myelopathy (CSM)

Answer 15

demyelination, tumours, rheumatoid arthritis, MND, Syringomyelia, subacute degeneration

Question 16

what are five differential diagnoses of Cervical Spondylosis Radiculopathy (CSR)

Answer 16

carpal tunnel syndrome, ulnar nerve palsy, thoracic outlet syndrome, shoulder girdle problems, brachial neuritis,

Question 17

what investigations are useful when investigating myelopathy and radiculopathy?

Answer 17

X RAY, MRI, CT, EMG/NCS

Question 18

how can CSR and CSM be managed?

Answer 18

conservative: analgesia, physiotherapy, collar SURGICAL: anterior, posterior.

Question 19

what are some risk factors for back pain, myelopathy & radiculopathy

Answer 19

smoking, pregnancy, certain professions