Cervical Spondylosis - Signs and symptoms

Distinct clinical syndromes observed for cervical spondylosis include headache, shoulder pain, pain suboccipitala, spondilotica cervical myelopathy and radicular symptoms. As disc degeneration is mechanical stress lead to bone spurs that form along the ventral face of the spinal canal.Frequently associated with degenerative changes occur in the joints, hypertrophy and ossification of yellow ligament, posterior longitudinal ligament. All these contribute to nerve compression and sensitive determination of various clinical syndromes.Spondylosis changes are seen frequently in older populations, however, only a small percentage of affected patients shows symptomatic radiographic changes.
Neck painSuboccipitala chronic headache is present. Mechanisms include direct nerve compression, degenerated disc, ligament or joint damage and segmental instability. Pain may be felt locally or can radiate occiput, shoulder, scapula, or arm. Pain that worsens when the patient sleeps and interfere with sleep in certain positions.
Cervical radiculopathyUNCRC cervical nerve root compression in ischemic changes that cause sensory dysfunction: radicular pain and motor dysfunction: weakness. Radiculopathy occurs mostly in people of 40-50 years.A herniated disc spondylosis acute or chronic changes can cause cervical radiculopathy and myelopathy. C6 root is commonly affected due to degeneration of C5-6 space predominant. Spaces are immediately affected C6 and 7. Radiculopathy Most cases resolve with conservative therapy, and some require surgery.
Cervical myelopathyThe most severe consequence of cervical intervertebral disc degeneration, especially when associated with cervical collapse.Cervical myelopathy has an insidious onset that is becoming apparent to people between 50-60 years. Full remission is rare once appeared myelopathy. Sphincter impairment is unusual presentation.
It describes five categories of cervical myelopathy, according to the main neurological elements:Transverse lesion-syndrome-tracts and tracts corticospinale spinotalamice as posterior columns are affectedSyndrome involving impaired motor-horn cells before or corticospinaleCords-syndrome-central motor and sensory involvement is greater in the upper extremities of the lower faceBrown-Sequard-syndrome-impaired wound cords unilateral corticospinal tract ipsilateral and contralateral analgesia below the lesion-Duper-medullary syndrome brahialgia predominant upper limb.
Less common manifestations include:Primary-glove sensory loss-Tandem spinal stenosis is a narrowing in the cervical and lumbar spondylosis simultaneous comprises a triad of symptoms: neurological claudication, abnormal weight complex, motor nerve signs of upper and lower limbs-Dysphagia may be present if bone spurs are high enough to compress the esophagusAnd vertigo, vertebrobasilar insufficiencyHemidiafragmului-rise caused by compression of spondylosis at C 3-4.
Neck compression test - sign SpurlingIf it is a positive diagnosis for cervical radiculopathy. test is performed by active extension to the patient's head pain during a chair seat. Then you press down to compress axially the ipsilateral neural foramen during flexion and rotation. Maneuver has a specificity of 100%. Other useful tests are test and test manual traction abducerii shoulder.
Mark HoffmanIt is a reflex contraction of the thumb and index finger after catching. The sign is valid only if associated with the motor neural elements. Another useful test is the pectoral muscle reflex. It is pointed out by tapping the muscle tendon deltopectorala pit with adductia and internal rotation of the shoulder if hyperactivity is present. A positive test suggests cervical spinal cord compression C2-4.
Mark LhemitteConsists of electric shock feeling going back to the center and stop in the States patient during neck flexion. This sign is not specific for cervical myelopathy and posterior column dysfunction is attributed to the classic.
Sensory abnormalitiesLoss of vibratory sense or proprioception in the extremities, especially in the legs is common. Spinotalamice sensitivity loss may be asymmetric.
Complications
Cervical myelopathy can cause disabilities who are divided as follows:-Grade 0-signs of root damage, without evidence of spinal damage-Degree-signs of spinal cord damage, but the patient's weight is normalSecond-degree is this affecting light weight,Third-grade abnormalities weightFourth-grade is possible only outpatient care-Degree V-related patient is bed-ridden or wheelchair.Other complications include:-Paraplegia, tetraplegia-Recurrent respiratory infections, bedsores.
Disease progression
Evolution of cervical spondylosis may be slow and prolonged, and patients can either remain asymptomatic or mild neck pain.Nonprogressive disability periods are typically long, and in some cases the patient's condition deteriorates. Morbidity ranges from chronic neck pain, radicular pain, reducing space motion, headache, myelopathy leading to weakness and impaired motor coordination until quadripareza sphincter dysfunction and in advanced cases. Patients may become wheelchair dependent.