Ch. 14 - Cervical disc disease and cervical spondylosis Flashcards Preview

Neurosurgery > Ch. 14 - Cervical disc disease and cervical spondylosis > Flashcards

Flashcards in Ch. 14 - Cervical disc disease and cervical spondylosis Deck (19)
Loading flashcards...
1

predominant sx of cervical spine disorders

neck pain and arm symptoms

2

cause of cervical spine disorders

degenerative changes in vertebral column = cervical disc disease and cervical spondylosis

3

most common level of cervical disc herniation

C6/7 > C5/6 (fulcrum of head/spine), otherwise uncommon

4

direction of disc herniation in cervical spine and implication

posterolaterally because PLL prevents direct posterior herniation ==> nerve root entrapment at the level of the spinal nerve (ie C5/6 prolapse = C6 nerve entrapment)

5

presentation of cervical disc herniation

"deep achy" neck and arm pain and neurologic manifestations of cervical nerve root compression (radiculopathy)

6

upper extremity dermatome

C5 - upper arm and forearm
C6 - shooter
C7 - middle finger
C8 - 4th/5th digits

7

upper extremity myotomes

shoulder: abduction C5, adduction: C6-8
elbow: flexion C5/6, extension: C7/8
Forearm: supinate C6, pronate C7/8
Wrist: flexion C6-8, extension C7/8
Intrinsic hands: C8/T1

8

Characteristic C6/7 disc prolapse

C7 nerve root compression = weakness with elbow extension, absent triceps jerk, numbness/tingling middle finger

9

UE reflexes

biceps - C5, brachioradialis - C6, triceps - C7

10

Characteristics of C5/6 disc prolapse

C6 nerve root compression = absent brachioradialis reflex, numbness/tingling of C6 shooter

11

Characteristics of C7/T1 disc prolapse

C8 nerve root compression = weakness in long flexors, triceps, finger extensors, intrinsic hand muscles, decreased sensation in 4th/5th digits

12

ddx disc prolapse

spinal tumor, thoracic outlet syndrome, pancoast's tumor, peripheral nerve entrapment

13

disc prolapse management

conservative - bed rest, cervical collar, NSAIDs, muscle relaxants

14

indications for surgical intervention of disc prolapse

pain > 10 days w/o relief, significant weakness, e/o myelopathy

15

Dx cervical disc prolapse with...

MRI

16

surgical interventions for disc prolapse

cervical foraminotomy with excision of prolapsed disc vs anterior cervical discectomy with fusion

17

disadvantage to anterior cervical discectomy with fusion

adjacent joint disease

18

cervical spondylosis

degenerative arthritic process of cervical spine

19

prevalence of cervical spondylosis in people >50

75%