Cervical Osteoarthritis: Difference between revisions
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<div class="noeditbox">Welcome to [[Vrije Universiteit Brussel Evidence-based Practice Project|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!!</div> <div class="editorbox"> | <div class="noeditbox">Welcome to [[Vrije Universiteit Brussel Evidence-based Practice Project|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!!</div> <div class="editorbox"> | ||
'''Original Editors ''' - [[User:Bram Sorel|Bram Sorel]], [[User:Lisa Pernet|Lisa Pernet]] | '''Original Editors ''' - [[User:Bram Sorel|Bram Sorel]], [[User:Lisa Pernet|Lisa Pernet]] | ||
'''Lead Editors''' - Your name will be added here if you are a lead editor on this page. [[Physiopedia:Editors|Read more.]] | '''Lead Editors''' - Your name will be added here if you are a lead editor on this page. [[Physiopedia:Editors|Read more.]] | ||
</div> | </div> | ||
== Search Strategy == | == Search Strategy == | ||
Databases used: Pubmed, Web of Knowledge, Pedro, Medal.org | Databases used: Pubmed, Web of Knowledge, Pedro, Medal.org | ||
Keywords Used: osteoarthritis, Cervical Arthrosis, Cervical spondylosis, Cervical Pain, Cervical Therapy | Keywords Used: osteoarthritis, Cervical Arthrosis, Cervical spondylosis, Cervical Pain, Cervical Therapy | ||
== Video Fragment<br> == | == Video Fragment<br> == | ||
== Definition/Description == | == Definition/Description == | ||
Cervical Osteoarthritis or [[Osteoarthritis|Osteoarthritis]] in the cervical spine may be defined as a chronic degenerative intervertebral disc protrusion which has caused secondary hyperthrophic osteophyte formation.<ref>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 (Level C)</ref> OA involves the zygapophyseal joints, which show degeneration of the articular surfaces and increased stiffness of subchondral bone.<ref>David J. Magee,James E. Zachazewski, William S. Quillen.Pathology and intervention in musculoskeletal rehabilitation:p25 (Book)</ref> | Cervical Osteoarthritis or [[Osteoarthritis|Osteoarthritis]] in the cervical spine may be defined as a chronic degenerative intervertebral disc protrusion which has caused secondary hyperthrophic osteophyte formation.<ref>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 (Level C)</ref> OA involves the zygapophyseal joints, which show degeneration of the articular surfaces and increased stiffness of subchondral bone.<ref>David J. Magee,James E. Zachazewski, William S. Quillen.Pathology and intervention in musculoskeletal rehabilitation:p25 (Book)</ref> | ||
== Epidemiology/Etiology == | == Epidemiology/Etiology == | ||
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.'''<ref>Robert W. Rand,Paul H. Crandall. Surgical Treatment of Cervical Osteoarthritis, California Medicine,91:185-188,1959 (Level B)</ref>''' | 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.'''<ref>Robert W. Rand,Paul H. Crandall. Surgical Treatment of Cervical Osteoarthritis, California Medicine,91:185-188,1959 (Level B)</ref>''' | ||
Everyone can have [[Osteoarthritis|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.<ref>Michael J.Lee,K.Daniel Riew. The prevalence cervical arthrosis:an osseous study in cadaveric population. The spine Journal,9:711-714,2009 (Level C)</ref><ref>Ilse Tuinhof,Bjorn Weijts. De fysiotherapeutische behandeling bij cervicale spondylarthrose, een literatuurstudie (Level B)</ref> | Everyone can have [[Osteoarthritis|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.<ref>Michael J.Lee,K.Daniel Riew. The prevalence cervical arthrosis:an osseous study in cadaveric population. The spine Journal,9:711-714,2009 (Level C)</ref><ref>Ilse Tuinhof,Bjorn Weijts. De fysiotherapeutische behandeling bij cervicale spondylarthrose, een literatuurstudie (Level B)</ref> | ||
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,... | 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.<ref>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 (Level C)</ref><br> | A relation has been shown between the severity of the complaints of Cervical OA and a higher body weight of the patient.<ref>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 (Level C)</ref><br> | ||
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.<ref>W.Alexander Miles. Discogenic and osteoarthritic Disease of the Cervical Spine. Journal of the National Medical Association,66:300-304,1974 (Level C)</ref> | 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.<ref>W.Alexander Miles. Discogenic and osteoarthritic Disease of the Cervical Spine. Journal of the National Medical Association,66:300-304,1974 (Level C)</ref> | ||
#Remote fall or head injury | #Remote fall or head injury | ||
#Similar type injuries at some time after the onset of symptoms with no evidence that the injury caused any exacerbation of the condition | #Similar type injuries at some time after the onset of symptoms with no evidence that the injury caused any exacerbation of the condition | ||
#Light cases with trauma followed by immediate appearence of symptoms of the first time | #Light cases with trauma followed by immediate appearence of symptoms of the first time | ||
| Line 37: | Line 50: | ||
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.<ref>W.Alexander Miles. Discogenic and osteoarthritic Disease of the Cervical Spine. Journal of the National Medical Association,66:300-304,1974 (Level C)</ref> | 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.<ref>W.Alexander Miles. Discogenic and osteoarthritic Disease of the Cervical Spine. Journal of the National Medical Association,66:300-304,1974 (Level C)</ref> | ||
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.<ref>Hugh H.Hussey. Primer on the Rheumatic Diseases. JAMA-Supplement. Intervertebral Disc Syndrome,224:746-747,1973</ref><ref>I.A. Kapandji. Bewegingsleer: De romp en wervelkolom,p257</ref> | 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.<ref>Hugh H.Hussey. Primer on the Rheumatic Diseases. JAMA-Supplement. Intervertebral Disc Syndrome,224:746-747,1973</ref><ref>I.A. Kapandji. Bewegingsleer: De romp en wervelkolom,p257</ref> | ||
There also can be circulation problems because of the narrowing of the spinal canal. | There also can be circulation problems because of the narrowing of the spinal canal. | ||
== Diagnostic Procedures == | == Diagnostic Procedures == | ||
add text here relating to diagnostic tests for the condition<br> | add text here relating to diagnostic tests for the condition<br> | ||
== Outcome Measures == | == Outcome Measures == | ||
add links to outcome measures here (see [[Outcome Measures|Outcome Measures Database]]) | add links to outcome measures here (see [[Outcome Measures|Outcome Measures Database]]) | ||
== Management / Interventions<br> == | == Management / Interventions<br> == | ||
The current standard therapy for Cervical OA consists of NSAID's, [[Exercise Therapy|Exercise_Therapy]], [[Manual Therapy|Manual_Therapy]], [[Physiotherapy / Physical Therapy|Physiotherapy_/_Physical_Therapy]] and various operations.<ref>Loy T. Treatment of cervical spondylosis. Med.J.Aust,2:32-34,1983 (Level C)</ref><br> | The current standard therapy for Cervical OA consists of NSAID's, [[Exercise Therapy|Exercise_Therapy]], [[Manual Therapy|Manual_Therapy]], [[Physiotherapy / Physical Therapy|Physiotherapy_/_Physical_Therapy]] and various operations.<ref>Loy T. Treatment of cervical spondylosis. Med.J.Aust,2:32-34,1983 (Level C)</ref><br> | ||
Functional status and disability measure can be assessed by [[Neck Pain and Disability Scale|Neck_Pain_and_Disability_Scale]] before and after therapy.<br> | Functional status and disability measure can be assessed by [[Neck Pain and Disability Scale|Neck_Pain_and_Disability_Scale]] before and after therapy.<br> | ||
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.<ref>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.,26:320-324,2006fckLR(Level A2)</ref> | 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.<ref>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.,26:320-324,2006fckLR(Level A2)</ref> | ||
== Differential Diagnosis<br> == | == Differential Diagnosis<br> == | ||
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. | 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. | If more than one joint in a group is assessed, then the most severe grade is reported. | ||
Parameters: | Parameters: | ||
#osteophytes at the joint margins and periarticular ossicles | #osteophytes at the joint margins and periarticular ossicles | ||
#narrowing of the joint space | #narrowing of the joint space | ||
#cystic areas with sclerotic wall in subchondral bone | #cystic areas with sclerotic wall in subchondral bone | ||
#deformity of bone | #deformity of bone | ||
{| width="200" cellspacing="1" cellpadding="1" border="1" | {| width="200" cellspacing="1" cellpadding="1" border="1" | ||
|- | |- | ||
| '''Radiological Appearence of OA''' | | '''Radiological Appearence of OA''' | ||
| '''Grade''' | | '''Grade''' | ||
|- | |- | ||
| normal (no signs of OA) | | normal (no signs of OA) | ||
| 0 | | 0 | ||
|- | |- | ||
| doubtful | | doubtful | ||
| 1 | | 1 | ||
|- | |- | ||
| definite, minimal to mild | | definite, minimal to mild | ||
| 2 | | 2 | ||
|- | |- | ||
| definite, moderate | | definite, moderate | ||
| 3 | | 3 | ||
|- | |- | ||
| definite, severe | | definite, severe | ||
| 4 | | 4 | ||
|} | |} | ||
| Line 95: | Line 128: | ||
add text here relating to key evidence with regards to any of the above headings<br> | add text here relating to key evidence with regards to any of the above headings<br> | ||
== Resources <br> == | == Resources <br> == | ||
add appropriate resources here | add appropriate resources here | ||
== Case Studies == | == Case Studies == | ||
add links to case studies here (case studies should be added on new pages using the [[Template:Case Study|case study template]])<br> | add links to case studies here (case studies should be added on new pages using the [[Template:Case Study|case study template]])<br> | ||
== References == | == References == | ||
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: | Levels of Evidence: | ||
<br> | <br> | ||
<references /> | <references /> | ||
[[Category:Vrije_Universiteit_Brussel_Project]] | [[Category:Vrije_Universiteit_Brussel_Project]] | ||
Revision as of 21:56, 25 May 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, Lisa Pernet
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]
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]
- Remote fall or head injury
- Similar type injuries at some time after the onset of symptoms with no evidence that the injury caused any exacerbation of the condition
- 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
[edit | edit source]
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
[edit | edit source]
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:
- osteophytes at the joint margins and periarticular ossicles
- narrowing of the joint space
- cystic areas with sclerotic wall in subchondral bone
- 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]
add links to case studies here (case studies should be added on new pages using the case study template)
References[edit | edit source]
References will automatically be added here, see adding references tutorial.
Levels of Evidence:
- ↑ 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 (Level C)
- ↑ David J. Magee,James E. Zachazewski, William S. Quillen.Pathology and intervention in musculoskeletal rehabilitation:p25 (Book)
- ↑ Robert W. Rand,Paul H. Crandall. Surgical Treatment of Cervical Osteoarthritis, California Medicine,91:185-188,1959 (Level B)
- ↑ Michael J.Lee,K.Daniel Riew. The prevalence cervical arthrosis:an osseous study in cadaveric population. The spine Journal,9:711-714,2009 (Level C)
- ↑ Ilse Tuinhof,Bjorn Weijts. De fysiotherapeutische behandeling bij cervicale spondylarthrose, een literatuurstudie (Level B)
- ↑ 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 (Level C)
- ↑ W.Alexander Miles. Discogenic and osteoarthritic Disease of the Cervical Spine. Journal of the National Medical Association,66:300-304,1974 (Level C)
- ↑ W.Alexander Miles. Discogenic and osteoarthritic Disease of the Cervical Spine. Journal of the National Medical Association,66:300-304,1974 (Level C)
- ↑ Hugh H.Hussey. Primer on the Rheumatic Diseases. JAMA-Supplement. Intervertebral Disc Syndrome,224:746-747,1973
- ↑ I.A. Kapandji. Bewegingsleer: De romp en wervelkolom,p257
- ↑ Loy T. Treatment of cervical spondylosis. Med.J.Aust,2:32-34,1983 (Level C)
- ↑ 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.,26:320-324,2006fckLR(Level A2)
