CERVICAL SPONDYLOSIS
DIAGNOSTIC CRITERIA
Definition : Chronic degenerative changes in the Cervical vertebrae and discs leading to herniation of disc material, calcification, and osteophyte formation.
- Could lead to compression on the nerve roots leading to radicular pain in the arms (Outer aspect down to elbow), sensory disturbances, and/or pain in the neck and occiput.
- Could lead to myelopathy due to direct pressure, vascular insufficiency, or repetitive trauma causing spastic weakness in the arms and legs, and /or posterior column or spinothalamic defects.
- Pressure on the vertebral arteries could cause dizziness, vertigo, and tinnitus.
- Limitation of neck extension, and lateral flexion noted in the great majority.
- AP, Lateral and both Oblique views of cervical spine demonstrate narrowing of disc spaces, osteophytes formation, encroachment on intervertebral foramina, but such changes are seen in most people after middle age.
- In diagnostic imaging, MRI is preferred to CT as changes in the cord can be visualised as well.
Prognosis: In the great majority of cases the course is benign, but there are exacerbations through ‘t1’c’e patient’s life with no known precipitating cause in most cases.
MANAGEMENT
General Measures
- Wearing a cervical coll( Velcro-fixed ) that would limit hyperextension or hypertlexion.
Patient teaching
- Not to engage in activity causing neck strain like - doing house work sitting on the floor, long distance travel by bus or car with neck flexed forward, moving around carrying a heavy weight improperly distributed between the two hands.
Follow up
Every month to assess any possible neurologic deficit developing.
