Wednesday, June 1, 2011

Cervical Spondylosis - Diagnosis

Laboratory studiesReagina plasma cyanocobalamin and help differentiate metabolic and infectious causes of the myelopathy spondylosis.
Imaging StudiesCervical radiography is a simple routine for every patient suspected of cervical spondylosis. This investigation assesses the face and joints, vertebral foramen, intervertebral spaces and formations osteofitice. In certain conditions it is necessary to detect cervical spine flexion instability. Radiograph showed collapse of the intervertebral space, osteophytosis, loss of cervical lordosis, joint hypertrophy uncovertebrale, apophysis joint osteoarthritis, spinal canal diameter.
Full myelography computed tomography scan is the imaging test of choice for evaluating spinal stenosis and the foramen.Myelography in evaluating spondylosis without anatomical information. It is useful to visualize the nerve roots. CT scan with or without intrathecal contrast is used to estimate the channel diameter. The scan can show small osteophytes, calcified opacity in the middle and lateral vertebral bodies.
MRI is helpful in the diagnosis of cervical spondylosis. Has advantages such as direct imaging in multiple planes, better define the neural elements, increased accuracy in the evaluation of spinal marrow diseases intrinsic neinvazivitatea, myelogram similar images.
Electromyography is useful in evaluating radiculopatiei caused by spondylosis, but is of limited value in evaluating myelopathy.Somatosensory evoked potential responses in myelopathy are Late or small amplitude. Cortical motor evoked potentials are more sensitive than those somatomotorii in evaluating spinal cord dysfunction. As a measure invasive cervical discography is not routinely used in evaluation of cervical spondylosis.
Histological examinationThinning and fragmentation of articular cartilage is a common element. Smooth surface, white and yellow joints become irregular.The continuing loss of cartilage leads to exposure of links subchondral bone area, which appears bright on the articular surface seal. Fibrosis, increased bone formation and cystic changes are common in exposed bone. Loss catilajului stimulates new bone formation in the form of nodules, bone spurs at the edges.

The differential diagnosis is made with the following conditions: the capsule adhesive, Brown-Sequard syndrome, carpal tunnel syndrome, central medullary syndrome, cervical disc disease, cervical miofasciala pain, diabetic neuropathy, multiple sclerosis, pain miofasciala, plexopatia brachial tumor, osteoporosis, arthritisarthritis, neuralgia occipital siringomielia, myocardial spinal cord syndrome, Whiplash, Pancoast tumors.

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