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.

scholarly journals Cervical spondylosis: analysis of clinical and radiological correlation

2018 ◽  
Vol 5 (2) ◽  
pp. 491 ◽  
Author(s):  
RoseBist P. K. ◽  
Anil Kumar Peethambaran ◽  
Gowri Anil Peethambar
Keyword(s):  
Neck Pain ◽  
Cervical Spondylosis ◽  
Wrist Joint ◽  
Tertiary Care ◽  
Japanese Orthopaedic Association ◽  
Cervical Radiculopathy ◽  
Intervertebral Discs ◽  
Radiological Findings ◽  
Tertiary Care Centre ◽  
Male Predominance

Background: Cervical spondylosis is a chronic degenerative lesion of the cervical intervertebral discs causing axial neck pain, cervical radiculopathy and myelopathy. This study was undertaken to study the clinical and radiological correlation in cervical spondylosis with respect to clinical and radiological findings.Methods: A prospective observational study was done on 100 patients with cervical spondylosis treated in a tertiary care centre of South Kerala. The sociodemographic details, clinical and radiological findings were recorded. Nurick’s grading and Modified Japanese orthopaedic association cervical spine myelopathy scoring was done. Data collected was analyzed using Microsoft Excel 2010 and results expressed in proportions.Results: Maximum prevalence was seen in 40-49 years group with male predominance. Majority of the patients had neck pain, sensory numbness and motor weakness. Spurling’s sign and Lhermitt’s sign was positive in 60% and 47% patients respectively. Complete paralysis was seen on both sides in 12% patients at wrist joint and 9% each in elbow and knee joints. Grade II cervical spondylosis was seen in 43%. Modified Japanese orthopaedic association score was less than 18 in all patients. Canal size was reduced in many. The clinical and radiological findings were consistent.Conclusions: Cervical spondylosis is seen in those above 30 years of age with male predominance. Clinical and radiological findings are consistent with each other. Further studies are advised for better correlation.

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.

scholarly journals The Biomechanics of Cervical Spondylosis

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Lisa A. Ferrara
Keyword(s):  
Risk Factor ◽  
Cervical Spine ◽  
Neck Pain ◽  
Load Balance ◽  
Cervical Spondylosis ◽  
Cervical Radiculopathy ◽  
Height Loss ◽  
Ventral Margin ◽  
Vascular Structures ◽  
Eventual Loss

Aging is the major risk factor that contributes to the onset of cervical spondylosis. Several acute and chronic symptoms can occur that start with neck pain and may progress into cervical radiculopathy. Eventually, the degenerative cascade causes desiccation of the intervertebral disc resulting in height loss along the ventral margin of the cervical spine. This causes ventral angulation and eventual loss of lordosis, with compression of the neural and vascular structures. The altered posture of the cervical spine will progress into kyphosis and continue if the load balance and lordosis is not restored. The content of this paper will address the physiological and biomechanical pathways leading to cervical spondylosis and the biomechanical principles related to the surgical correction and treatment of kyphotic progression.

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.

scholarly journals Tropism of Sub-Axial Cervical Facet Joints Is Not Related to Segmental Movement during Active Movement or Therapist-Perceived Symptomatic Locations

Symmetry ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 739
Author(s):  
Neil Tuttle ◽  
Kerrie Evans ◽  
Clarice Sperotto dos Santos Rocha
Keyword(s):  
Cervical Spine ◽  
Neck Pain ◽  
Active Movement ◽  
Facet Joints ◽  
Segmental Mobility ◽  
Limited Mobility ◽  
Translational Movement ◽  
The Difference ◽  
Cervical Facet ◽  
The Relationship

Tropism, or asymmetry, of facet joints in the cervical spine has been found to be related to degenerative changes of the joints and discs. Clinicians often assume that differences in segmental mobility are related to tropism. The aims of this study were to determine the relationship between asymmetry of facet joints in the sub-axial cervical spine and (1) segmental mobility and (2) spinal levels perceived by therapists to have limited mobility. Eighteen participants with idiopathic neck pain had MRIs of their cervical spine in neutral and at the end of active rotation. Angular movement and translational movement of each motion segment was calculated from 3D segmentations of the vertebrae. A plane was fitted to the facet on each side. Tropism was considered to be the difference in the orientation of the facet planes and ranged from 1 to 30° with a median of 7.7°. No relationships were found between the extent of tropism and either segmental movement or locations deemed to be symptomatic. Tropism in the sub-axial cervical spine does not appear to be related to segmental mobility in rotation or to levels deemed to be symptomatic.

Cervical pneumatocyst

2011 ◽  
Vol 15 (3) ◽  
pp. 332-335 ◽  
Author(s):  
Jason M. Hoover ◽  
Doris E. Wenger ◽  
Laurence J. Eckel ◽  
William E. Krauss
Keyword(s):  
Cervical Spine ◽  
Carpal Tunnel Syndrome ◽  
Neck Pain ◽  
Carpal Tunnel ◽  
Chronic Neck Pain ◽  
Cervical Radiculopathy ◽  
Disc Disease ◽  
Left Hand ◽  
Tunnel Syndrome ◽  
Multilevel Fusion

The authors present the case of a 56-year-old right hand–dominant woman who was referred for chronic neck pain and a second opinion regarding a cervical lesion. The patient's pain was localized to the subaxial spine in the midline. She reported a subjective sense of intermittent left arm weakness manifesting as difficulty manipulating small objects with her hands and fingers. She also reported paresthesias and numbness in the left hand. Physical and neurological examinations demonstrated no abnormal findings except for a positive Tinel sign over the left median nerve at the wrist. Electromyography demonstrated bilateral carpal tunnel syndrome with no cervical radiculopathy. Cervical spine imaging demonstrated multilevel degenerative disc disease and a pneumatocyst of the C-5 vertebral body. The alignment of the cervical spine was normal. A review of the patient's cervical imaging studies obtained in 1995, 2007, 2008, and 2010 demonstrated that the pneumatocyst was not present in 1995 but was present in 2007. The lesion had not changed in appearance since 2007. At an outside institution, multilevel fusion of the cervical spine was recommended to treat the pneumatocyst prior to evaluation at the authors' institution. The authors, however, did not think that the pneumatocyst was the cause of the patient's neck pain, and cervical pneumatocysts typically have a benign course. As such, the authors recommended conservative management and repeated MR imaging in 6 months. Splinting was used to treat the patient's carpal tunnel syndrome.

scholarly journals Operative Techniques for Cervical Radiculopathy and Myelopathy

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
C. Moran ◽  
C. Bolger
Keyword(s):  
Cervical Spine ◽  
Cervical Spondylosis ◽  
Cervical Radiculopathy ◽  
Cervical Disc ◽  
Cervical Disc Arthroplasty ◽  
Past Century ◽  
Operative Techniques ◽  
Disc Arthroplasty ◽  
The Past ◽  
Surgical Options

The surgical treatment of cervical spondylosis and resulting cervical radiculopathy or myelopathy has evolved over the past century. Surgical options for dorsal decompression of the cervical spine includes the traditional laminectomy and laminoplasty, first described in Asia in the 1970's. More recently the dorsal approch has been explored in terms of minimally invasive options including foraminotomies for nerve root descompression. Ventral decompression and fusion techniques are also described in the article, including traditional anterior cervical discectomy and fusion, strut grafting and cervical disc arthroplasty. Overall, the outcome from surgery is determined by choosing the correct surgery for the correct patient and pathology and this is what we hope to explain in this brief review.

Analysis of the uncinate processes of the cervical spine: an anatomical study

2012 ◽  
Vol 16 (4) ◽  
pp. 402-407 ◽  
Author(s):  
R. Shane Tubbs ◽  
Olivia J. Rompala ◽  
Ketan Verma ◽  
Martin M. Mortazavi ◽  
Brion Benninger ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Anatomical Study ◽  
Axial Rotation ◽  
Intervertebral Discs ◽  
Uncinate Process ◽  
Surgical Approaches ◽  
Intervertebral Foramen ◽  
Facet Joints ◽  
Vertebral Level ◽  
Arthritic Changes

Object Although the uncovertebral region is neurosurgically relevant, relatively little is reported in the literature, specifically the neurosurgical literature, regarding its anatomy. Therefore, the present study aimed at further elucidation of this region's morphological features. Methods Morphometry was performed on the uncinate processes of 40 adult human skeletons. Additionally, range of motion testing was performed, with special attention given to the uncinate processes. Finally, these excrescences were classified based on their encroachment on the adjacent intervertebral foramen. Results The height of these processes was on average 4.8 mm, and there was an inverse relationship between height of the uncinate process and the size of the intervertebral foramen. Degeneration of the vertebral body (VB) did not correlate with whether the uncinate process effaced the intervertebral foramen. The taller uncinate processes tended to be located below C-3 vertebral levels, and their average anteroposterior length was 8 mm. The average thickness was found to be 4.9 mm for the base and 1.8 mm for the apex. There were no significant differences found between vertebral level and thickness of the uncinate process. Arthritic changes of the cervical VBs did not necessarily deform the uncinate processes. With axial rotation, the intervertebral discs were noted to be driven into the ipsilateral uncinate process. With lateral flexion, the ipsilateral uncinate processes aided the ipsilateral facet joints in maintaining the integrity of the ipsilateral intervertebral foramen. Conclusions A good appreciation for the anatomy of the uncinate processes is important to the neurosurgeon who operates on the spine. It is hoped that the data presented herein will decrease complications during surgical approaches to the cervical spine.

scholarly journals Development of differentiated surgical technique for treating patients with multilevel degenerative diseases of cervical spine

2019 ◽  
pp. 47-54
Author(s):  
V. A. Byvaltsev ◽  
A. A. Kalinin ◽  
M. A. Aliyev ◽  
V. V. Shepelev ◽  
B. R. Yusupov ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Disease Duration ◽  
Intervertebral Discs ◽  
Adverse Outcomes ◽  
Neurological Symptoms ◽  
Cervical Region ◽  
Degenerative Diseases ◽  
Facet Joints ◽  
On Line ◽  
Surgical Tactics

Background. Currently, there is no uniform tactics for the differentiated use of dorsal decompressive-stabilizing techniques for multilevel degenerative diseases of the cervical spine, and the results of these technologies application are largely controversial.Aim. Analysis of the unsatisfactory outcomes of dorsal decompressive-stabilizing interventions in the treatment of patients with multilevel degenerative diseases of the cervical spine and development of a clinicalinstrumental algorithm for differentiated surgical tactics.Material and methods. A retrospective study included 112 patients with degenerative diseases of the cervical spine at two levels or more due to hernias of intervertebral discs, yellow ligament hypertrophy and arthrosis of facet joints, which in 2007-2014 underwent dorsal decompressive-stabilizing interventions in the volume of laminotomy with laminoplasty (LP) and laminectomy with fixation for lateral masses (LF). A correlation analysis of clinical parameters with anamnestic data, instrumental parameters, a feature of accepted surgical tactics and postoperative adverse effects.Results. In the analysis, it was established that «satisfactory» postoperative outcomes of LP are associated with a neutral or lordotic configuration of the cervical spine, the preservation of segmental movements without clinical and instrumental signs of instability; In addition, the use of LF is possible with mobile kyphotization of the cervical spine and the presence of translational instability of the cervical segments. The «unsatisfactory» postoperative results of the LP and LF are in direct correlation with the duration of the disease, the presence of myelopathic focus and rigid kyphosis of the cervical region.Conclusion. Differential use of dorsal decompressive-stabilizing techniques based on a comprehensive assessment of disease duration, configuration of the cervical spine, spinal cord condition and volume of segmental movements allows to reduce neurological symptoms, improve the level of pain and improve the functional status of patients, as well as significantly reduce the number of adverse outcomes associated with the progression of kyphotic deformity, deterioration of neurological symptoms and revision on-line decompressive-stabilizing interventions. 

scholarly journals Cervical Spondylosis Management through the Spactacles of Homoeopathy

2021 ◽  
Vol 10 (1) ◽  
pp. 649-655
Author(s):  
Shashi Bhushan Singh ◽  
◽  
Ravi Prakash ◽  
Keyword(s):  
Risk Factor ◽  
Cervical Spine ◽  
Soft Tissue ◽  
Neck Pain ◽  
Intervertebral Disc ◽  
Cervical Spondylosis ◽  
Soft Tissues ◽  
Holistic Approach

Cervical spondylosis is one of the commonly seen diseases nowadays. Neck pain, which usually arises from diseases of the cervical spine & soft tissues of the neck, is common. “SPONDYLO” is a Greek term, meaning “Vertebra” & spondylosis generally mean changes in the vertrbral joint characterized by increasing degeneration of the intervertebral disc with subsequent changes in the bones & soft tissue. The management of cervical spondylosis is very much effective with Homoeopathic medicine. This article stress upon the risk factor, pathophysiology, symptomatology, investigation in concise manner as well as emphasises how homoeopathy can manage in such cases by its holistic approach of treatment.

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