Spine: Spondylosis Flashcards
What is Spondylosis?
Progressive degenerative process affecting the vertebral bodies + intervertebral discs, causing compression of the spinal cord +/- nerve roots
Describe the aetiology of Spondylosis
Osteoarthritic degeneration of vertebral bodies leads to formation of osteophytes
Osteophytes protrude on to the foramina + spinal canal
This leads to compression of:
Nerve roots: radiculopathy
Anterior spinal cord: myelopathy
List 3 risk factors for Spondylosis
Genetics
Age
Spinal injures
Describe the epidemiology of Spondylosis
Mean age at diagnosis = 48 yrs
M > F
Lumbar + cervical spondylosis are the most common
How may Spondylosis present?
Can be ASYMPTOMATIC
Back + neck pain which can radiate down the arms due to pinched nerve
List 4 general symptoms of Spondylosis
Limited flexion of the spine
Paraesthesia
Weakness
Stiff legs + Gait disturbance
List 5 signs seen in the arms caused by Spondylosis
Atrophy of forearm/ hand muscles
Segmental muscle weakness in nerve root distribution
Hyporeflexia
Sensory loss: pain + temperature
Pseudoathetosis: writhing finger motions when hands are outstretched, fingers spread, eyes closed
List 5 signs seen in the legs caused by Spondylosis
Increased tone Weakness Hyper-reflexia Extensor plantar response Reduced proprioception + vibration sensation
Give 2 signs of Spondylosis
Lhermitte’s Sign
Hoffman’s Sign
What may be seen on Spinal XR of Spondylosis?
Osteoarthritic change in the cervical spine
Rarely diagnostic in nontraumatic
What may be seen on MRI of Spondylosis?
Assessment of root + root compression, to exclude spinal cord tumour, nerve root infiltration by tumour/ granulomatous tissue
What signs are caused in the arms and legs in Spondylosis?
ARMS (cervical): LMN signs
LEGS: if cervical cord compression: UMN signs
List 4 symptoms of cervical spondylosis
Numbness in fingertips/ clumsiness in hands
Atypical chest pain
Breast pain
Facial pain
What may lesions at C5/6 cause on examination?
Inverted reflexes due to LMN impairment at the level of compression + UMN impairment below the level
= Supinator reflex elicits finger flexion + not elbow flexion
What is Lhermitte’s Sign?
neck flexion causes crepitus (grating sound) +/- paraesthesia down the spine
