Cervical Pathology Flashcards Preview

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Flashcards in Cervical Pathology Deck (14):


primarily muscle and/or ligamentous strain
can be associated with bony/joint injuries/dysfunction
MOI - acc/dec involving rapid and uncontrolled ext/flex
potential for vertebral artery injury
often associated with dizziness and headache in addition to spasm


Whiplash Management

AVOID - forceful use of muscle, traction, aggressive massage (esp along length of muscle), joint mob
may need support - soft collar for short period of time
restore normal pain-free active mobility and muscle balance (CON, ECC, endurance)



potential for lateral or central stenosis
decreased IVF space (lateral) or cord space (central)
disc space narrowing


Spondylosis Signs and Symptoms

cervical radiculopathy
headaches that radiate to back of head
cervical myelopathy - cord compression - more diffuse UE symptoms/clumsiess, may have LE UMN symptoms


Spondylosis Surgical Management

laminoplasty - open hinge to decompress cord and nerve roots
- supportive collar post-op for several weeks, gradual mobility and strengthening afterwards


Disc-Related Disorders

most common - C4-5, C5-6
cervical roots exit ABOVE corresponding vertebra (C5 exits between C4-5 segment, C8 below C7)
often associated with UE radiculopathy
bulge/herniation may be ant or post


ACDF Management

anterior cervical discectomy and fusion

post-op brace until bone heals (graft usually from iliac crest)
no - lifting overhead and no lifting beyond 10 lb, driving, repetitive bending
take small bites and chew well


Jefferson Fx (C1)

burst fx of ring structure of C1 = combined fx of ant and post arches
moderately unstable
MOI - axial compression often from fall on head
may have associated head injuries


Jefferson Fx Treatment

nondisplaced - philly or four poster type brace
displaced - halo traction
bone healing - 8-16 weeks


Odontoid Fx (C2) MOI, Treatment and Management

MOI - combo of flex/rot and ex
I - fx of tip; soft collar
II - fx at base or neck; halo or operation and then halo vest
III - fx extends body of atlas; usualy halo traction, then halo vest, immobilized 12-16 weeks


Hangman's Fx (C2)

Fx of neutral arch of C2 = separation of body from post elements
MOI - forceful ext of already ext neck, mostly MVA


Hangman's Fx (C2) Treatment and Management

I - philly collar or four poster
II - closed reduction with axial traction, immobilized in halo vest brace
III - ORIF with post fusion of C2-C3 then halo vest
All types immobilized 8-12 weeks


Whiplash Classification

0 - no symptom of neck pain or physical signs
1 - neck symptom (pain, stiffness, or tenderness only), no physical signs
2 - neck symptom, musculoskeletal symptoms (decreased ROM, point tenderness)
3 - neck symptom, musculoskeletal signs, neruological signs (decreased/absent DTRs, muscle weakness, sensory deficits)
4 - neck symptoms and fx/dislocation



A - neck pain, motor impairment (dereased ROM, altered muscle recruitment patterns), sensory impairment (local cervical mechanical hyperalgia)
B - neck pain, motor and sensory impairment, psychological impairment (elevated psychological distress)
- neck, pain
- motor impairment (all and increased joint positioning errors)
- sensory impairment (all and generalized sensory hypersensitivity [mechanical, thermal, B ULTT 1 limitation], some may show SNS disturbances)
- psychological impairment - all and elevated levelso f acute posttraumatic stress