Cervical Osteoarthritis: Difference between revisions
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References will automatically be added here, see [[Adding References|adding references tutorial]].  
References will automatically be added here, see [[Adding References|adding references tutorial]].  
Levels of Evidence:


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[[Category:Vrije_Universiteit_Brussel_Project]]
[[Category:Vrije_Universiteit_Brussel_Project]]

Revision as of 20:53, 22 March 2011

Welcome to Vrije Universiteit Brussel's Evidence-based Practice project. This space was created by and for the students in the Rehabilitation Sciences and Physiotherapy program of the Vrije Universiteit Brussel, Brussels, Belgium. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!

Original Editors - Bram Sorel

Lead Editors - Your name will be added here if you are a lead editor on this page.  Read more.

Search Strategy[edit | edit source]

Databases used: Pubmed, Web of Knowledge, Pedro, Medal.org

Keywords Used: osteoarthritis, Cervical Arthrosis, Cervical spondylosis, Cervical Pain, Cervical Therapy

Video Fragment
[edit | edit source]

[Link To Video Fragment Cervical Arthrosis]

Definition/Description[edit | edit source]

Cervical Osteoarthritis or Osteoarthritis in the cervical spine may be defined as a chronic degenerative intervertebral disc protrusion which has caused secondary hyperthrophic osteophyte formation.[1] OA involves the zygapophyseal joints, which show degeneration of the articular surfaces and increased stiffness of subchondral bone.[2]

Epidemiology/Etiology[edit | edit source]

Cervical Osteoarthritis may be generalized, sometimes involving the entire cervical region, but it is usually more localized between the fifth and sixth and sixth and seventh cervical vertebrae.[3]

Everyone can have Osteoarthritis and Cervical OA, but it is rare in people younger than 40-50 years. The prevalence rises over time. Also women have a higher risk than men.[4][5]

The occurance of Cervical OA can have many causes. E.g. mechanically overstressing a joint (working with tools that generate intense vibration), past bone fractures, overload at young age, posture asymmetry or asymmetric loading of a joint,...

A relation has been shown between the severity of the complaints of Cervical OA and a higher body weight of the patient.[6]

Brain et al. evaluated a series of 45 cases. Twenty-nine had no history of trauma. The primary cause is not known. The other cases fell into three groups.[7]

  1. Remote fall or head injury
  2. Similar type injuries at some time after the onset of symptoms with no evidence that the injury caused any exacerbation of the condition
  3. Light cases with trauma followed by immediate appearence of symptoms of the first time

Characteristics/Clinical Presentation[edit | edit source]

The usual complaints are pain in the neck and pain referred to the medial border of the scapula. The pain is often associated with movement restrictions and stiffness in the neck.[8]

Pressure symptoms in the cervical spine are caused by Osteoarthritis of the uncovertebral joints. Osteophytes can form around the intevertebral joints. This can result in compression of the spinal nerve between the osteophytes and the remainder of the intervertebral joints. The more common location of C6 and C7 may show subjective sensory defects over the radial aspects of the forearm, thumb and index fingers.[9][10]

There also can be circulation problems because of the narrowing of the spinal canal.

Diagnostic Procedures[edit | edit source]

add text here relating to diagnostic tests for the condition

Outcome Measures[edit | edit source]

add links to outcome measures here (see Outcome Measures Database)

Management / Interventions
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The current standard therapy for Cervical OA consists of NSAID's, Exercise_Therapy, Manual_Therapy, Physiotherapy_/_Physical_Therapy and various operations.[11]

Functional status and disability measure can be assessed by Neck_Pain_and_Disability_Scale before and after therapy.

Magnetic therapy represents an alternative therapy for patients suffering from Cervical Osteoarthritis. Electromagnetic fields can be applied to treat Cervical OA. A pain-relief effect of PEMF has been proposed, but further studies are needed.[12]

Differential Diagnosis
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Kellgren and Lawrence developed a grading system for the radiological appearence of a joint with OA. The authors are from the University of Manchester and the Empire Reumatism Council Field Unit.

If more than one joint in a group is assessed, then the most severe grade is reported.

Parameters:

  1. osteophytes at the joint margins and periarticular ossicles
  2. narrowing of the joint space
  3. cystic areas with sclerotic wall in subchondral bone
  4. deformity of bone
Radiological Appearence of OA Grade
normal (no signs of OA) 0
doubtful  1
definite, minimal to mild 2
definite, moderate 3
definite, severe 4

Key Evidence[edit | edit source]

add text here relating to key evidence with regards to any of the above headings

Resources
[edit | edit source]

add appropriate resources here

Case Studies[edit | edit source]

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References[edit | edit source]

References will automatically be added here, see adding references tutorial.

Levels of Evidence:


  1. ↑ Payne, Eric E., Spillane John D.The cervical spine, an anatomico-pathological study of 70 specimens (using a special technique) with particular reference to the problem of cervical spondylosis, Brain, 80:571-596,1959
  2. ↑ David J. Magee,James E. Zachazewski, William S. Quillen.Pathology and intervention in musculoskeletal rehabilitation:p25
  3. ↑ Robert W. Rand,Paul H. Crandall. Surgical Treatment of Cervical Osteoarthritis, California Medicine,91:185-188,1959
  4. ↑ Michael J.Lee,K.Daniel Riew. The prevalence cervical arthrosis:an osseous study in cadaveric population. The spine Journal,9:711-714,2009
  5. ↑ Ilse Tuinhof,Bjorn Weijts. De fysiotherapeutische behandeling bij cervicale spondylarthrose, een literatuurstudie
  6. ↑ Hartz A.J.,Fisher M.E.,Bril G.,et al. The association of obesity with joint pain and osteoarthritis in the HANES data. J. Chronic Dis.,39:311-319,1986
  7. ↑ W.Alexander Miles. Discogenic and osteoarthritic Disease of the Cervical Spine. Journal of the National Medical Association,66:300-304,1974
  8. ↑ W.Alexander Miles. Discogenic and osteoarthritic Disease of the Cervical Spine. Journal of the National Medical Association,66:300-304,1974
  9. ↑ Hugh H.Hussey. Primer on the Rheumatic Diseases. JAMA-Supplement. Intervertebral Disc Syndrome,224:746-747,1973
  10. ↑ I.A. Kapandji. Bewegingsleer: De romp en wervelkolom,p257
  11. ↑ Loy T. Treatment of cervical spondylosis. Med.J.Aust,2:32-34,1983
  12. ↑ Serap Tomruk Sutbeyaz,Nebahat Sezer,Belma Fusun Koseoglu. The effect of pulsed electromagnetic fields in the treatment of cervical osteoarthritis: a randomized, double-blind, sham-controlled trial. Rheumatol. Int.,26:320-324,2006
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