Cervical Spondylosis

Question 1

What is cervical spondylosis commonly called?

Answer 1

Arthritis of the neck

Question 2

Cervical spondylosis is very common, affecting what percentage of over 60s?

Answer 2

85%

Question 3

Degeneration of the cervical spine with age is inevitable and has a wide clinical spectrum from asymptomatic to…

Answer 3

Progressive spastic quadriparesis and sensory loss due to compression of the cord

Question 4

What is the annulus fibrosus?

Answer 4

The strong wrapping that makes the outside portion of the intervertebral disc.

Made up of concentric sheets of collagen fibres (orientated at various angles) - type 1 and 2 collagen

Encloses the nucleus pulposus

Question 5

What are the ligaments of the spine called?

Answer 5

Anterior longitudinal ligament 
Posterior longitudinal ligament
Ligamentum flavum 
Interspinal ligament
Supraspinous ligament

Question 6

Where is ligamnetum flavum located?

Answer 6

Run between adjacent laminae of the vertebral bodies

Present from C2/3 to sacrum

Question 7

Describe the pathogenesis

Answer 7

Degeneration of the annulus fibrosis combined with osteophyte formation on the adjacent vertebra leads to narrowing of the spinal canal and the intervertebral foramina.

As neck flexes and extends the cord is dragged over the protruding bony spurs anteriorly and a thickened ligamentum flavum posteriorly

Question 8

How does it present?

Answer 8

Neck stiffness
Crepitus only moving neck
Stabbing or dull arm pain
Forearm or wrist pain

Question 9

What are associated signs?

Answer 9

Limited painful neck movement +/- crepitus
Neck flexion may produce tingling down spine (Lhermitte’s sign)

Root compression: pain/ electrical sensations in arms or fingers at level of compression. Numbness, dull reflexes, weakness, wasting

Features of cord compression: progressive symptoms,

Question 10

What is another word for root compression?

Answer 10

Radiculopathy