spondylosis and radiculopathy

Question 1

whats is cervical spondylosis

Answer 1

Ageing causes wear and tear to muscles and bones.

Question 2

define spondylosis

Answer 2

degenerative conditions affecting the disks, vertebral bodies, and/or associated joints of the lumbar spine

Question 3

symptoms of cervical spondylosis

Answer 3

neck and shoulder pain or stiffness – that comes and goes

headaches that often start at the back of the neck

Question 4

Tx for cervical spondylosis

Answer 4

exercises

paon medication

Question 5

when is surgery considered in cervical spondylosis

Answer 5

a nerve is being pinched by a slipped disc or bone (cervical radiculopathy)
there’s a problem with your spinal cord (cervical myelopathy)

Question 6

causes if cervical spondylosis

Answer 6

your job involves repetitive neck movements or a lot of overhead work – like painting and decorating
you have previously had a neck injury
you have a family history of the condition

Question 7

define lumbar spondylosis

Answer 7

wear and tear in the discs and facet joints

discs become thinner and bone spurs - osteophytes form at the edges of the joints

Question 8

symptoms of lumbar spondylosis

Answer 8

Stiffness.
• Pain.
• Restriction in movement, for example difficulty arching back.
• Creaking and clicking in the back.
• Pain referred to buttocks and/or leg.

Question 9

what is lumbar radiculopathy

Answer 9

impingement of lumbosacral nerve roots as they emerge from the spinal canal, and are felt in the distribution of the nerve root (dermatome)

alterantives - nerve root pain, radicular pain, sciatica

Question 10

causes of sciatica

Answer 10

slipped disc
spondylolisthesis
spinal stenosis

Question 11

symptoms of sciatica

Answer 11

unlateral radiating leg pain
low back pain
numbness, tingling paraesthesia

posditcie straight leg raising test

Question 12

what is radiculopathy

Answer 12

conduction block in the axons of a spinal nerve or its roots, with impact on motor axons causing weakness and on sensory axons causing paraesthesia and/or anaesthesia.

Question 13

causes of radiculopathy

Answer 13

intervertebral disc prolapse
degenerative diseases of spine
fracture
malignancy
infection - potts, osteomyelitis, abscess, herpes zoster

Question 14

features of radiculopathy

Answer 14

sensory - paraesthesia and numbness

motor - weakness

Question 15

Tx for radiculopathy

Answer 15

analgesia

neuropathic pain medications

physio important

Question 16

what is degenerative cervical myelopathy (DCM)

Answer 16

age related osteoarthritis changes cause narrowing of the cervical spinal canal leading to chronic spinal cord compression

Question 17

DCM Sx

Answer 17

• Pain (affecting the neck, upper or lower limbs)
• Loss of motor function (loss of digital dexterity, preventing simple tasks such as holding a fork or doing up their shirt buttons, arm or leg weakness/stiffness leading to impaired gait and imbalance
• Loss of sensory function causing numbness
• Loss of autonomic function (urinary or faecal incontinence and/or impotence) - these can occur and do not necessarily suggest cauda equina syndrome in the absence of other hallmarks of that condition
• Hoffman’s sign: is a reflex test to assess for cervical myelopathy. It is performed by gently flicking one finger on a patient’s hand. A positive test results in reflex twitching of the other fingers on the same hand in response to the flick.

Question 18

gold standard test for DCM

Answer 18

MRI

disc degeneration
ligament hypertrophy