neck conditions Flashcards
what are the most commonly fractured segments in the Cx spine?
C2, followed by C6-7
in the C1 vertebra, what structure is most commonly fractured?
the posterior arch (hyperextension injury) –> risk for vertebral artery injury
what is a Jefferson’s burst fracture?
compression fracture of C1
if the lateral mass offset >2 mm –> transverse ligament rupture
what are the most common fractures at C2?
- Dens fracture
- Hangman’s fracture –> bilateral pedicle fracture (can also occur in the lower cx)
- extension teardrop fracture –> avulsion of the anterior-inferior C2 VB
(flexion teardrop fracture –> fracture is in the antero-inferior VB of C4-6, highly unstable!)
what is the name of an avulsion fracture of the spinous process?
Clay-Shovelers fx
what is the most common level of cervical radiculopathy?
C6-7 (then C5-6)
what are the most common symptoms of Cx radiculopathy?
cx pain, arm pain, paraesthesia, pain around the superior angle of the scapula
when can you diagnose Cx radiculopathy?
Wainner’s item cluster:
1. <60° cx rotation towards symptomatic side
2. Cx compression aggravates pain
3. Cx distraction reliefs pain
4. UL nerve tension tests reproduce arm pain
what LMNL symptoms may be detected in Cx radiculopathy?
decrease reflexes
weakness
atrophy
fasciculations
hypotonia
what are is the difference between a cervical myelopathy and a radiculopathy?
in a radiculopathy, the nerve routes in the cervical spine are damaged
in a myelopathy, the spinal cord within the neck is damaged
what are the most common symptoms of a cervical myelopathy?
cx pain, arm pain, paraesthesia and hyperesthesia in arm
leg stiffness/heaviness/clumsiness, difficulties walking
in a patient with cervical myelopathy, where are the UMNL and the LMNL?
LMNL are at the level of the lesion (decrease reflexes, weakness, atrophy, fasciculations and hypotonia)
UMNL are below the lesion (increased reflexes, hypertonicity, +ve rhomberg’s, +ve babinski, +ve Hoffmann’s)
what is the most common age of patients diagnosed with torticollis?
15-30yrs
what is the MC level affected by torticollis?
C2-3
what are the most common symptoms of torticollis?
unilateral neck pain, neck usually laterally flexes away from painful side, neck is ‘stuck’
mostly sudden onset
