Spondys

Question 1

Cervical spondylitis symptoms (6)

Answer 1

• condition is often asymptomatic but in 10% to 15% of the population it is associated with spinal root or cord compression
• osteophytic formation can result in reduced rom
• neck and shoulder pain, this may be chronic or episodic
• suboccipital headache characterised by a deep dull constant throbbing at the base of the occiput
• cervical spondylosis can progress to cervical spondylotic myelopathy

Question 2

Cervical spondylosis symptoms: cervical radiculopathy (4)

Answer 2

• damage or compression of a nerve root as it exits the spinal cord from the cervical region
• degenerative changes of the facet joints and osteopphytic formation cause narrowings which pinch the nerve roots
• a prolapsed cervical disc can also cause cervical radiculopathy
• sympoms include: neck pain, numbness, tingling, pins and needles, pain and weakness in parts of the arm or hand supplied by the nerve root

Question 3

What can cervical spondylosis progress to? (1)

Answer 3

-cervical spondylotic myelopathy

Question 4

Cervical spondylosis orthotic objectives (4)

Answer 4

• to restrict cervical motion, in particular extension, lateral flexion and rotation
• to hold the neck in slight flexion, allowing the vertebral foramina to open up and relieve nerve root impingement
• circumferential containment: this will provide warmth, intersegmental motion control and also will aid in reducing inflammation or spasms
• pschological restraint

Question 5

Degenerative changes in a cervical vertebrae (4)

Answer 5

• degeneration (osteophyte) not causing problems
• degen (osteophyte) irritating or pressing on nerve root coming out from spinal cord. This is one cause of cervical radiculopathy
• prolapsed disc pressing on a nerve root coming from the spinal cord. This is one cause of cervical radiculopathy
• degeneration (osteophyte) pressing on spinal cord, this is one cause of a cervical myelopathy

Question 6

Cervical spondylosis (6)

Answer 6

• age related degenerative condition of the cervical spine
• primarily the intervertebral discs and also the vertebrae
• in vertbrae with intervertebral discs so pathological changes occur in c3-c7
• these degen changes start after age 30 and include:
  
  • osteophytic formation at the disc margins
  • narrowing of disc space due yo dehydration of intervertebral discs

Question 7

Cervical spondylotic myelopathy / CSM (5)

Answer 7

• csm is the most common cause of spinal cord dysfunction/non-traumatic parapesis in older adults
• the most common cause of cervical spondylotic myelopathy is cevical spondylosis
• in csm occurs when there is pressure or damage to the spinal cord
• a prolapsed cervical intervertebral disc can cause myelopathy if the prolapse is into the central canal of the vertebra (toward the spinal cord)
• cervical spondylotic myelopathy significantly affects patients’ quality of life, it can lead to anxious or depressive moods relating to decreased mobility

Question 8

Csm symptoms (6)

Answer 8

• unsteady gait, lower limbs feel stiff and clumsy
• trunk numbness/hypersensitivity
• limb weakness
• atrophy
• spasticity
• bladder sphincter dysfunction

Question 9

Csm management (2)

Answer 9

• surgical if spinal cord involvement

- conservative management depending on symptoms

Question 10

Cam conservative management (10)

Answer 10

• medication
• cervical immobilisation
  
  • orthosis
• mobilisation
  
  • manipulation
  • exercise
• reeducation
  
  • posture
  • adl
• physiological intervention

Question 11

Csm orthotic management (3)

Answer 11

• minerva: cto
• halo orthosis
• aim of interventjon is to immobilise cervical spine

Question 12

Csm halo (4)

Answer 12

• maximum gross motion control
• skull fixation proximally
• distal component for attachment of uprights
• can be modified to apply traction

Question 13

Spondylosis (2)

Answer 13

• assoiated problems: spinal stenosis, spondylolisthesis

- symptoms include:pain, altered sensation, muscular weakness

Question 14

Spinal stenosis (2)

Answer 14

• an abnormal narrowing of the spinal canal that may be either congenital or acquired. Treatment is generally surgical, to widen spinal canal
• laminectomy may be indicated surgical procedure to reduce pressure on the spinal cord

Question 15

Spondylolisthesis ( 2)

Answer 15

-forward slippage of a vertebra and the spine above it in relation to the vertebra below it, most typically l5 on s1 however l4 on l5 may be observed

Question 16

Spondylolysis (4)

Answer 16

• not to be confused with spondylosis
• the pars interarticularis is found in the posterior portion of the vertebra
• spondylolysis occurs when there is a fracture of the pars portion of the vertebra
• spondylolisthesis occurs when the vertebra shifts forward due to instability from the pars defect (not always in the presence of a fracture of the pars interticularis)