alexa Cervical Spondylosis | Canada | PDF | PPT| Case Reports | Symptoms | Treatment

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Cervical Spondylosis

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  • Cervical Spondylosis

    Cervical Spondylosis refers to common agerelated changes in the area of the spine at the back of the neck. With age, the vertebrae (thecomponent bones of the spine) gradually form bone spurs, and their shockabsorbing disks slowly shrink. These changes can alter thealignment and stability of the spine. They may go unnoticed, or they may produce problems related to pressure on the spine andassociated nerves and blood vessels. This pressure can cause weakness, numbness, and pain in various areas of the body. In severecases, walking and other activities may be compromised.
  • Cervical Spondylosis

    Causes and symptoms: As people age, shrinkage of the vertebral disks prompts the vertebrae to form osteophytes to stabilize the back bone. However, theposition and alignment of the disks and vertebrae may shift despite the osteophytes. Symptoms may arise from problems with one ormore disks or vertebrae. Osteophyte formation and other changes do not necessarily lead to symptoms, but after age 50, half of the population experiencesoccasional neck pain and stiffness. As disks degenerate, the cervical spine becomes less stable, and the neck is more vulnerable toinjuries, including muscle and ligament strains. Contact between the edges of the vertebrae can also cause pain. In some people, thispain may be referred—that is, perceived as occurring in the head, shoulders, or chest, rather than the neck. Other symptoms may includevertigo (a type of dizziness) or ringing in the ears. The neck pain and stiffness can be intermittent, as can symptoms of radiculopathy. Radiculopathy refers to compression on the base, orroot, of nerves that lead away from the spinal cord. Normally, these nerves fit comfortably through spaces between the vertebrae. Thesespaces are called intervertebral foramina. As the osteophytes form, they can impinge on this area and gradually make the fit between thevertebrae too snug. The poor fit increases the chances that a minor incident, such as overdoing normal activities, may place excess pressure on the nerveroot, sometimes referred to as a pinched nerve. Pressure may also accumulate as a direct consequence of osteophyte formation. Thepressure on the nerve root causes severe shooting pain in the neck, arms, shoulder, and/or upper back, depending on which nerve rootsof the cervical spine are affected. The pain is often aggravated by movement, but in most cases, symptoms resolve within four to sixweeks. Cervical spondylosis can cause cervical spondylitic myelopathy through stenosis- or osteophyte-related pressure on the spinal cord.Spinal stenosis is a narrowing of the spinal canal—the area through the center of the vertebral column occupied by the spinal cord.Stenosis occurs because of misaligned vertebrae and out-of-place or degenerating disks. The problems created by spondylosis can beexacerbated if a person has a naturally narrow spinal canal. Pressure against the spinal cord can also be created by osteophytes formingon the inner surface of vertebrae and pushing against the spinal cord. Stenosis or osteophytes can compress the spinal cord and its bloodvessels, impeding or choking off needed nutrients to the spinal cord cells; in effect, the cells starve to death. With the death of these cells, the functions that they once performed are impaired. These functions may include conveying sensoryinformation to the brain or transmitting the brain's commands to voluntary muscles. Pain is usually absent, but a person may experienceleg numbness and an inability to make the legs move properly. Other symptoms can include clumsiness and weakness in the hands,stiffness and weakness in the legs, and spontaneous twitches in the legs. A person's ability to walk is affected, and a wide-legged,shuffling gait is sometimes adopted to compensate for the lack of sensation in the legs and the accompanying, realistic fear of falling. Invery few cases, bladder control becomes a problem.
  • Cervical Spondylosis

    Diagnosis: Cervical spondylosis is often suspected based on the symptoms and their history. Careful neurological examination can help determinewhich nerve roots are involved, based on the location of the pain and numbness, and the pattern of weakness and changes in reflexresponses. To confirm the suspected diagnosis, and to rule out other possibilities, imaging tests are ordered. The first test is an x ray. Xrays reveal the presence of osteophytes, stenosis, constricted space between the vertebrae, and misalignment in the cervical spine—inshort, an x ray confirms that a person has cervical spondylosis. To demonstrate that the condition is causing the symptoms, more detailsare needed. Other imaging tests, such as magnetic resonance imaging (MRI) and computed tomography myelography, help assesseffects of cervical spondylosis on associated nerve tissue and blood vessels. An MRI may be preferred, because it is a noninvasive procedure and does not require injecting a contrast medium as does computedtomography myelography. MRIs also have greater sensitivity for detecting disk problems and spinal cord involvement, and the test allowsthe physician to create images of a larger area from various angles. However, these images may not show enough detail about thevertebrae themselves. Computed tomography myelography yields a superior image of the bones involved in cervical spondylosis. Addedbenefits include that it takes less time to perform and tends to be less expensive than an MRI. A good diagnosis may be reached witheither a computed tomography myelography or an MRI, but sometimes complementary information from both tests is necessary. Nerveconduction velocity, electromyogram (EMG), and/or somatosensory evoked potential testing may help to confirm which nerve roots areinvolved.
  • Cervical Spondylosis

    STATISTICS: To quantify the scope of neck and back problems, we surveyed 70 interventional electrophysiologists in Canada using an electronic survey with in person and email reminders. We also surveyed an age- and gender-matched group of noninterventional cardiologists. We received responses from a total of 58 of 70 interventional electrophysiologists (response rate 82.8%). There was a significantly higher prevalence of cervical spondylosis among electrophysiologists compared to matched noninterventional cardiologists (20.7% compared to 5.5%, P = 0.033). There was a trend for increased prevalence of lumbar spondylosis (25.9% compared to 16.7%, P = 0.298). Among electrophysiologists, those with cervical spondylosis were older (49.83 ± 10.48 years compared to 44.57 ± 9.20, P = 0.092) and had worked in the specialty for longer in comparison to unaffected physicians (19.67 ± 10.06 years compared to 13.37 ± 8.97 years, P = 0.039).
  • Cervical Spondylosis

    STATISTICS: To quantify the scope of neck and back problems, we surveyed 70 interventional electrophysiologists in Canada using an electronic survey with in person and email reminders. We also surveyed an age- and gender-matched group of noninterventional cardiologists. We received responses from a total of 58 of 70 interventional electrophysiologists (response rate 82.8%). There was a significantly higher prevalence of cervical spondylosis among electrophysiologists compared to matched noninterventional cardiologists (20.7% compared to 5.5%, P = 0.033). There was a trend for increased prevalence of lumbar spondylosis (25.9% compared to 16.7%, P = 0.298). Among electrophysiologists, those with cervical spondylosis were older (49.83 ± 10.48 years compared to 44.57 ± 9.20, P = 0.092) and had worked in the specialty for longer in comparison to unaffected physicians (19.67 ± 10.06 years compared to 13.37 ± 8.97 years, P = 0.039).

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