Cervical spondylosis

 ♦️Cervical spondylosis

 Or

♦️Osteoarthritis of cervical spine

 ▪️ Degenerative changes appear early in life in cervical spine, often during the third decade.

▪️ The disc space between the #5th & #6th cervical vertebrae is most frequently involved.

▪️ The earliest changes are confined to the disc, but the facet joints & uncovertebral joints may soon become involved.

▪️ There is inevitable #restriction of movements at the affected level.

▪️In many cases symptoms occur after being triggered by minor trauma.

▪️ Pain may be felt centrally in the neck and may #radiate to the occiput, giving rise to

severe occipital headache which may be confused with migraine.

▪️ Pain may also radiate distally, to the region of the lower scapulae.

▪️With nerve root involvement from arthritic changes in the facet or

uncovertebral joints, there may be radiation of pain into the shoulders, arms & hands, with paraesthesia.

▪️In most severe cases, there may be absent arm reflexes, muscle weakness, and sensory impairment.

▪️ In cervical spondylosis the cervical canal may be narrowed by osteophytic lipping, by central disc herniations, by thickening of the ligamentum flava, or even from local cervical vertebral subluxations associated with ligamentous laxity.

▪️ The reduction in the size of the canal may lead to cord compression (cervical

spondylotic #myelopathy).

▪️The disturbance of cord function may cause neck pain, difficulty in walking and unsteadiness on the feet,

numbness, paraesthesia, weakness, and loss of upper limb dexterity.

▪️ In myelopathy, bladder dysfunction may occur, but is not common, and extensor plantar responses may appear late.

▪️ Severe progressive myelopathy from spinal stenosis often requires

operative treatment by decompression & stabilization.

▪️ Osteophytes arising from the anterior vertebral margins may sometimes,

because of their size, give rise to dysphagia.

▪️ The mainstay of treatment in spondylosis is the judicious use of a cervical collar and prescription of analgesics.

▪️ If root symptoms are

prominent, intermittent or continuous, cervical traction is often employed.

▪️ Severe, protracted symptoms may be investigated further. If a positive lesion is diagnosed, a local cervical fusion may

sometimes be advised.