4- Spondylosis, Cervical Stenosis, Cervical Myelopathy
Spondylosis
What is it an where?
What else is it called? ️Spondylosis-
Age-related, degenerative changes that begin at the IV disc and subsequently involve other tissues - -Articular cartilage of facet joint -Bones of cervical spine -...
Age-related, degenerative changes that begin at the IV disc and subsequently involve other tissues -
-Articular cartilage of facet joint
-Bones of cervical spine - pts will experience a lot of flexibility loss
-Uncinate processes and uncovertebral joints
Natural History of Spondylosis in C/Spine
85% of patients over 65 have what?
Gradual or Sudden? What Pain distribution?
Unilateral or Bilateral?
Decreases primarily in which motions?
Morning stiffness for how long?
Most common levels affected? ✔️-85% over 65 have radiographic changes - doesn't indicate they will
be symptomatic
-Gradual onset of symptom in the cervical spine and/or arm which increase in frequency and severity
with time
-Typically present with unilateral pain distribution
, -Decreased sagittal plane motion: Extension more pain & limited than Flexion
-Decreased frontal plane motion: Side-bend & Rotation to the same side
-Morning stiffness which improves through the day (30 min) or less
Most common levels affected:
C5-6 & C6-7
Clinical Presentation Divided into 4 groups
Which one has the most serious consequences after middle age? ✔️-Neck pain
-Neck pain with proximal referral
-Radicular pain
-Myelopathy
Cervical spondylitic myelopathy is the most serious consequence AND is the most common C/S cord
disorder after middle age
Treatment Options (5/6) ✔️Cervical Manual Therapy
Thoracic Manual Therapy
Intermittent Cervical Traction
Muscle Strengthening of DNF
Upper Quarter Exercises
Pt education?
Cervical Stenoisis
What is it? What two kinds?
Associated with what?
More common in what age group?
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