CERVICAL SPONDYLOSIS ANATOMY

Neurosurgery ◽  
2007 ◽  
Vol 60 (suppl_1) ◽  
pp. S1-7-S1-13 ◽  
Author(s):  
Daniel Shedid ◽  
Edward C. Benzel
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Cervical Spondylosis ◽  
Developmental Process ◽  
Intervertebral Discs ◽  
Mechanical Pressure ◽  
Spine Mobility ◽  
Multiple Levels ◽  
External Forces ◽  
Progressive Disorder

Abstract CERVICAL SPONDYLOSIS IS the most common progressive disorder in the aging cervical spine. It results from the process of degeneration of the intervertebral discs and facet joints of the cervical spine. Biomechanically, the disc and the facets are the connecting structures between the vertebrae for the transmission of external forces. They also facilitate cervical spine mobility. Symptoms related to myelopathy and radiculopathy are caused by the formation of osteophytes, which compromise the diameter of the spinal canal. This compromise may also be partially developmental. The developmental process, together with the degenerative process, may cause mechanical pressure on the spinal cord at one or multiple levels. This pressure may produce direct neurological damage or ischemic changes and, thus, lead to spinal cord disturbances. A thorough understanding of the biomechanics, the pathology, the clinical presentation, the radiological evaluation, as well as the surgical indications of cervical spondylosis, is essential for the management of patients with cervical spondylosis.

Clinical recording of pressure on the spinal cord and cauda equina

1982 ◽  
Vol 57 (1) ◽  
pp. 64-66 ◽  
Author(s):  
Bjørn Magnaes
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Endotracheal Intubation ◽  
Cervical Spondylosis ◽  
Cauda Equina ◽  
Upper Cervical Spine ◽  
Lower Cervical Spine ◽  
Skeletal Traction ◽  
Neck Extension ◽  
Content Type

✓ Pressure on the spinal cord with the neck in the extended position for endotracheal intubation was recorded in eight patients with a narrow spinal canal due to cervical spondylosis. Pressures up to about 1400 mm H2O were recorded. Longitudinal skeletal traction with the tong placed frontally reduced the pressure on the spinal cord in all patients. When longitudinal skeletal traction was applied, the stress of the neck extension was probably in part transferred from the lower cervical spine where the canal was narrow to the upper cervical spine with the more spacious canal. Placing the tong for longitudinal skeletal traction frontally when performing endotracheal intubation is advocated in patients with cervical spondylosis and probably also in patients with injuries of the lower cervical spine.

A BIOMECHANICAL STUDY OF THE EFFECTS OF FLEXION ANGLE ON THE INDUCTION MECHANISM OF CERVICAL SPONDYLOSIS

2021 ◽  
pp. 2150053
Author(s):  
FU CAO ◽  
RONGCHANG FU ◽  
WENYUAN WANG
Keyword(s):  
Cervical Spine ◽  
Cervical Spondylosis ◽  
Element Model ◽  
Intervertebral Discs ◽  
Biomechanical Study ◽  
Flexion Angle ◽  
Facet Joints ◽  
Load Increase ◽  
Spine Motion ◽  
Wolff’S Law

Lesions in facet joints such as bone hyperplasia and degenerative changes in the intervertebral discs, can compress nerve roots and the spinal cord, leading to cervical spondylosis (CS). Lesions in these parts of the spine are commonly related to abnormal loads caused by bad posture of the cervical spine. This study aimed to understand the potential mechanical effects of load amplitude on cervical spine motion to provide a theoretical basis for the biomechanical causes of CS, and to provide a reference for preventing of the condition. In this study, a finite element model of the normal human cervical spine (C1-C7) was established and validated using an infrared motion capture system to analyze the effects of flexion angle on the stresses experienced by intervertebral discs, the anterior edge of the vertebral body, the pedicle, uncinate and facet joints. Our analysis indicated that the intervertebral disc load increased by at least 70% during the 20∘ to 45∘ flexion of the neck with 121% load increase in the vertebrae. In the intervertebral discs, the stress was largest at C4-C5, and the stress was moderate at C5-C6. These results are consistent with clinical CS prone site research. According to Wolff’s law, when bones are placed under large stresses, hyperplasia can result to allow adaptation to large loads. Increased cervical spine flexion angles caused the proliferation of bone in the above-mentioned parts of the spine and can accelerate accelerating the appearance of CS.

Dynamic electrophysiological examination of cervical flexion myelopathy

2008 ◽  
Vol 9 (2) ◽  
pp. 180-185 ◽  
Author(s):  
Yoshihiko Kato ◽  
Yasuaki Imajo ◽  
Tsukasa Kanchiku ◽  
Takanori Kojima ◽  
Hideo Kataoka ◽  
...  
Keyword(s):  
Decision Making ◽  
Spinal Cord ◽  
Cervical Spine ◽  
Real Time ◽  
Intervertebral Discs ◽  
Anterior Fusion ◽  
Electrophysiological Examination ◽  
Cervical Flexion Myelopathy ◽  
Spinal Cord Function ◽  
Spinal Flexion

Cervical flexion myelopathy is thought to arise following compression of the spinal cord by vertebrae or intervertebral discs and dura mater, or from overstretching of the spinal cord induced by cervical spinal flexion. However, the influence of spinal flexion on the spinal cord and the detailed origins of this disease are unknown. In this article the authors report a case of cervical flexion myelopathy in which dynamic electrophysiological examination was performed using an epidural electrode. This investigation showed the real-time influence of flexion of the cervical spine on spinal cord function. This technique was considered to be useful for diagnosis and in decision making for treatment. Anterior fusion was the optimal surgical method for treating this disease.

scholarly journals A Review on Diagnosis and Management of Cervical Spondylosis

2021 ◽  
pp. 668-674
Author(s):  
Ahmed Abdulaziz G. Ibrahim ◽  
Ali Mohammed A. Alahmari ◽  
Abdullah Hassan F. Alsuayri ◽  
Abdullah Misfer M. Algomshah ◽  
Saeed Ghanem S. Almlfi ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Neck Pain ◽  
Cervical Spondylosis ◽  
Natural Aging ◽  
Posterior Longitudinal Ligament ◽  
Cervical Radiculopathy ◽  
Intervertebral Discs ◽  
Degenerative Changes ◽  
Facet Joints ◽  
Wide Range

Cervical spondylosis is a term that encompasses a wide range of progressive degenerative changes that affect all components of the cervical spine (i.e., intervertebral discs, facet joints, Luschka joints, flava ligaments, and laminae). It is a natural aging process and occurs in most people after the age of five. Most people with radiographic spondylotic changes in the cervical spine  remain asymptomatic, and 25% of those under  40, 50% of those over  40, and 85% of those over  60 show some evidence of degenerative changes , including changes in  the environment. Uncovertebral joints, facet joints, posterior longitudinal ligament (PLL) and yellow ligament lead to  narrowing of the spinal canal and intervertebral foramina. As a result, the spinal cord, spinal vasculature, and nerve roots can become compressed, leading to the three clinical syndromes that occur with cervical spondylosis: axial neck pain, cervical myelopathy, and cervical radiculopathy. Cervical spondylosis is usually diagnosed for clinical reasons only, but imaging is also required. Treatment for cervical spondylosis can be medical or surgical, depending on whether the patient has symptoms of myelopathy, radicular pain, or neck pain.

Cervical Radiculopathy

2018 ◽  
pp. 101-108
Author(s):  
Michael Karsy ◽  
Ilyas Eli ◽  
Andrew Dailey
Keyword(s):  
Cervical Spine ◽  
Neck Pain ◽  
Cervical Spondylosis ◽  
Cervical Radiculopathy ◽  
Surgical Approaches ◽  
Anatomical Landmarks ◽  
Cervical Fusion ◽  
Spine Mobility ◽  
Posterior Cervical Fusion ◽  
Spine Disease

Degenerative cervical spondylosis resulting in cervical radiculopathy or myelopathy can be a significant source of morbidity for patients. Traditional surgical approaches have involved anterior or posterior cervical fusion with decompression; however, these techniques may result in higher cost compared with noninstrumented cases, reduction of spine mobility, and adjacent level disease. Anterior microforaminotomy, first described by Jho in 1996, involves a microdiscectomy and decompression of the cervical spine without arthrodesis. Posterior approaches to the foramina can also be an option. In this chapter, the authors describe the use of lateral disc foraminotomies in the treatment of cervical spine disease. These techniques are mainly for the treatment of cervical radiculopathy without instability or mechanical neck pain. Techniques for both anterior and posterior approaches, including pitfalls and key anatomical landmarks, are described.

Acute Traumatic Cervical Facet Fractures

2018 ◽  
Vol 1 (2) ◽  
pp. 5
Author(s):  
Shankar Gopinat
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Early Surgery ◽  
Initial Assessment ◽  
Trauma Patients ◽  
Spinal Stability ◽  
Fracture Patterns ◽  
Spine Ct ◽  
Cervical Facet

Acute cervical facet fractures are increasingly being detected due to the use of cervical spine CT imaging in the initial assessment of trauma patients. For displaced cervical facet fractures with dislocations and subluxations, early surgery can decompress the spinal cord and stabilize the spine. For patients with non-displaced cervical facet fractures, the challenge in managing these patients is the determination of spinal stability. Although many of the patients with non-displaced cervical facet fractures can be managed with a cervical collar, the imaging needs to be analyzed carefully since certain fracture patterns may be better managed with early surgical stabilization.

A scientific research study on the management of Manyasthamba (Cervical Spondylosis) with Nasya and Nasapana

2019 ◽  
Vol 4 (04) ◽  
Author(s):  
Unnikrishnan V S ◽  
Prashanth A S ◽  
Madhusudan Kulkarni
Keyword(s):  
Spinal Cord ◽  
Clinical Data ◽  
Food Habits ◽  
Cervical Spondylosis ◽  
Research Study ◽  
Weight Bearing ◽  
Scientific Research ◽  
Modern Era ◽  
Treatment Aspect

The science of life Ayurveda, not only deals with the prevention of diseases by maintaining health but also with the alleviation of diseases. In this ultra modern era due to change in lifestyles, sedentary works and food habits, people are unable to follow the Dinacharya and Ritucharya as explained in the classics, which may lead to different diseases. Due to improper postural habits, weight bearing and other unwholesome diets and habits there are higher the chances of discomfort and disease pertaining to spinal cord. Manyasthambha is one such condition that disturbs a big population due to today’s alterations in lifestyle. Here an effort is made to study and understand the role of Nasya Karma, Nasaapana and Shamanaushadhi like Vyoshadi Guggulu in the treatment aspect of this disease. Nasya Karma and Nasaapana provided highly significant results in all the symptoms of Manyasthambha. As per the clinical data, ‘Nasaapana is found to be more effective than Nasya Karma’. So it can be concluded that better results can be obtained with Shaddharana Yoga as Amapachana, Nasaapana with Mashabaladi Kwatha followed by Vyoshadi Guggulu as Shamanoushadhi.

scholarly journals Operative Treatment of Severe Cervical Spine Injuries Sustained in Youth Sports: Experience from a Pediatric Level 1 Trauma Center over a 16-Year Period

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0008
Author(s):  
Bram P Verhofste ◽  
Daniel J Hedequist ◽  
Craig M Birch ◽  
Emily S Rademacher ◽  
Michael P Glotzbecker ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Trauma Center ◽  
Youth Sports ◽  
Axial Loading ◽  
Permanent Disability ◽  
Cervical Spine Injuries ◽  
Cord Injury ◽  
Spine Injuries ◽  
Level 1

Background: Sports-related cervical spine injuries (CSI) are devastating traumas with the potential for permanent disability. There is a paucity of literature on operative CSI sustained in youth athletes. Hypothesis/Purpose: The aims of this study aims were to review injury characteristics, surgical treatment, and outcomes of severe pediatric CSI encountered in youth sports. Methods: We reviewed children less than 18 years old with operative sports-related CSI at a pediatric Level 1 pediatric trauma center between 2004−2019. All cases underwent modern cervical spine instrumentation and fusion. SCI were stratified according to the American Spinal Injury Association Impairment Scale (ASIA). Clinical, radiographic, and surgical characteristics were compared between groups of patients with and without spinal cord injury (SCI). Results: Three thousand two hundred and thirty-one children (mean, 11.3y±4.6y) were evaluated for CSI at our institution during the 16-year period. The majority of traumas resulted from sports/recreational activities and were seen in 1365 cases (42.3%). Of these, 171/1365 patients (12.5%) were admitted and 29/1365 patients (2.1%) required surgical intervention (mean age, 14.5y±2.88y; range, 6.4y–17.8y). Sports included: eight football (28%), seven wrestling (24%), five gymnastics (17%), four diving (14%), two trampoline (7%), one hockey (3%), one snowboarding (3%), and one biking injury (3%). Mechanisms were 19 hyperflexion (65%), eight axial loading (28%), and two hyperextension injuries (7%). The majority of operative CSI were fractures (79%) and/or subaxial defects (72%). Seven patients (30%) sustained SCI and three patients (10%) spinal cord contusion or myelomalacia without neurologic deficits. The risk of SCI increased with age (15.8y vs. 14.4y; p=0.03) and axial loading mechanism (71% vs. 14%; p=0.003). Postoperatively, two SCI patients (29%) improved 1 ASIA Grade and one (14%) improved 2 ASIA Grades. Increased complications developed in SCI than patients without SCI (mean, 2.0 vs 0.1 complications; p=0.02). Clinical and radiographic fusion occurred in 24/26 patients (92%) with adequate follow-up (median, 32 months). Ten patients returned to their previous activity and nine to sports with a lower level of activity. Conclusion: The overall incidence of sports-related operative CSI is low. Age- and gender discrepancies exist, with male adolescent athletes most commonly requiring surgery. Hyperflexion injuries had a good prognosis; however, older males with axial loading CSI sustained in contact sports were at greatest risk of SCI, complications, and permanent disability. [Figure: see text][Table: see text][Table: see text]

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