What is cervical spondylosis?
Degeneration of the cervical intervertebral discs
Spondylosis of the cervical spine predisposed to which condition?
OA of the cervical spine
How do patients with spondylosis of the cervical spine present?
- Slow onset stiffness
- Pain in the neck
- Radiation of pain to the occiput and shoulder
What is the mainstay of treatment for cervical spine spondylosis?
Physio and analgesia
Osteophytes may impinge on nerve roots in the cervical spine which may result in what?
Radiculopathy involving the upper limb dermatomes and myotomes
Impinging osteophytes in the cervical spine may require what treatment?
Decompression (for severe symptoms)
If patients have nerve root compression secondary to cervical disc prolapse, what do they complain of?
Shooting neuralgic pain down a dermatomal distribution
(there may be weakness and loss of reflexes)
Typically, in cervical disc prolapse, the ________ nerve root is involved
A large central disc prolapse in the cervical spine may lead to what?
Myelopathy with upper motor neurone symptoms and signs
What are signs and symptoms of upper motor neurone disruption?
- Wide based gait
- Increased tone
- Upgoing plantar response
Atraumatic cervical spine instability can occur in which two conditions mainly?
- Down syndrome
Children with down syndrome are at risk of developing which type of cervical instability and subluxation?
(this may also lead to spinal cord compression)
How can children with down syndrome be screened to check for abnormal motion in the cervical region?
What is the recommendation for children with
a) Minor degrees of cervical instability
b) Severe degrees of cervical instability
a) Avoidance of high impact sport
b) Surgical stabilisation (especially if there is abnormal neurology)
Why does atlanto-axial subluxation occur in patients with RA?
There is destruction of the connecting synovial joint
(and potentially also rupture of the transverse ligament)
Spinal cord compression due to atalnto-axial subluxation in RA can be _______
How are patients with atlanto-axial subluxation treated?
- Wearing a collar (to prevent flexion)
- More severe cases mandate surgical fusion
Lower cervical subluxation are due to what?
- Destruction of the synovial facet joints
- Destruction of the synovial uncovertebral joints
Lower cervical subluxations can also present with _______ _________ __________ signs
Upper motor neurone