Cervical Spondylosis: Difference between revisions
No edit summary |
No edit summary |
||
| Line 42: | Line 42: | ||
== Medical Management<ref name="Benatar">Benatar M., Neuromuscular Disease - Evidence and Analysis in Clinical Neurology, Humana Press Inc., Totowa, NJ, 2006, p. 61-78.</ref> <ref name="Macnab">Macnab I. Cervical spondylosis. Clin Orthop Relat Res. 1975;(109):69-77.</ref> <br> == | == Medical Management<ref name="Benatar">Benatar M., Neuromuscular Disease - Evidence and Analysis in Clinical Neurology, Humana Press Inc., Totowa, NJ, 2006, p. 61-78.</ref> <ref name="Macnab">Macnab I. Cervical spondylosis. Clin Orthop Relat Res. 1975;(109):69-77.</ref> <br> == | ||
The most commonly used medical treatment in patients with cervical spondylosis is a conservative treatment. This includes pharmacological treatments (NSAID’s, opioids, …), lifestyle modifications (neck schools, ergonomics, workplace modifications, …) and physical therapy (see chapter | The most commonly used medical treatment in patients with cervical spondylosis is a conservative treatment. This includes pharmacological treatments (NSAID’s, opioids, …), lifestyle modifications (neck schools, ergonomics, workplace modifications, …) and physical therapy (see next chapter: “Physical Therapy Management”). There isn’t enough evidence for neck immobilisation: various sources contradict each other.<br> | ||
== Physical Therapy Management <br> == | == Physical Therapy Management <br> == | ||
Revision as of 12:08, 9 January 2011
Original Editors - Gertjan Peeters
Lead Editors - Your name will be added here if you are a lead editor on this page. Read more.
Search Strategy[edit | edit source]
First I’ve used Pubmed and PEDro, where I combined various terms – such as: cervical spondylosis, cervical disc degeneration, physical therapy, physiotherapy, treatment, … – to search articles on this topic. Through this way I’ve found some studies and reviews. Unfortunately the most of this studies and reviews are quite old. Therefore I decided to search more information about this topic in the medical library of the VUB and in another library. After a while I found some books with primarily medical information about this subject and some books about the physiotherapeutic options.
Definition/Description [1] [2] [3] [4] [5][edit | edit source]
Cervical Spondylosis is a degenerative disorder at the level of the cervical spine. It can be described as the result of degeneration of the intervertebral discs or the corpus vertebrae in the cervical region. Possible characteristics are Degenerative_Disc_Disease, the formation of osteophytes, facet and uncovertebral joint arthritis, ossification of the posterior longitudinal ligament, hypertrophy of the ligamentum flavum, spinal stenosis. In some cases this degeneration also leads to a posterior protrusion of the annulus fibers of the intervertebral disc. This protrusion can cause compression of nerve roots, which in turn can lead to pain, motor disturbances such as muscle weakness, and sensory disturbances. As the spondylosis progresses there may be even interference with the blood supply to the spinal cord where the vertebral canal is narrowest.
Clinically Relevant Anatomy[edit | edit source]
add text here
Epidemiology /Etiology[edit | edit source]
Various sources report that the sixth and seventh nerve roots are the most commonly involved nerve roots. This means that cervical spondylosis mainly affects C5-C6 and C6-C7. A 1992 study[6] showed that spondylotic changes are most common in persons older than 40 years. Another conclusion of this study is that more than 70% of men and women are affected. And using radiographic evaluation it was also found that these changes are more severe in men than in women. Other studies report that cervical spondylosis may affect males earlier than females, but this studies report also that this is not true in all studied populations.
Characteristics/Clinical Presentation[edit | edit source]
Pain, paresthesias or muscle weakness, or a combination of these symptoms are the most common symptoms in patients with cervical spondylosis. A 1996 study[5] report that intermittent neck and shoulder pain is the most common syndrome seen in clinical practice. Another study[7] showed that, due to cervical radiculopathy, the pain most often occurs in the cervical region, the upper limb, shoulder, and/or interscapular region. In some cases the pain may be atypical and manifest as chest pain or breast pain. This study also reports that the pain is most frequently present in the upper limbs and the neck. Another study[8] showed that also chronic suboccipital headache could be a clinical syndrome in patients with cervical spondylosis. This headache may radiate to the base of the neck and the vertex of the skull. Also central cord syndrome is a syndrome that may be seen in relation to cervical spondylosis. 2 studies[9][10] demonstrate that in some cases dysphagia or airway dysfunction has been reported to cervical spondylosis. Various studies[4][6][8] report that cervical spondylosis often causes cervical spondylotic myelopathy.
Differential Diagnosis[edit | edit source]
add text here
Diagnostic Procedures[edit | edit source]
add text here related to medical diagnostic procedures
Outcome Measures[edit | edit source]
add links to outcome measures here (also see Outcome Measures Database)
Examination[edit | edit source]
add text here related to physical examination and assessment
Medical Management[2] [3]
[edit | edit source]
The most commonly used medical treatment in patients with cervical spondylosis is a conservative treatment. This includes pharmacological treatments (NSAID’s, opioids, …), lifestyle modifications (neck schools, ergonomics, workplace modifications, …) and physical therapy (see next chapter: “Physical Therapy Management”). There isn’t enough evidence for neck immobilisation: various sources contradict each other.
Physical Therapy Management
[edit | edit source]
add text here
Key Research[edit | edit source]
add links and reviews of high quality evidence here (case studies should be added on new pages using the case study template)
Resources
[edit | edit source]
add appropriate resources here
Clinical Bottom Line[edit | edit source]
add text here
Recent Related Research (from Pubmed)[edit | edit source]
see tutorial on Adding PubMed Feed
Extension:RSS -- Error: Not a valid URL: Feed goes here!!|charset=UTF-8|short|max=10
References[edit | edit source]
see adding references tutorial.
- ↑ MacSween R.N.M., Whaley K., Muir’s textbook of pathology – thirteenth edition, Edward Arnold, Great Britain, 1992, p. 853-854.
- ↑ 2.0 2.1 Benatar M., Neuromuscular Disease - Evidence and Analysis in Clinical Neurology, Humana Press Inc., Totowa, NJ, 2006, p. 61-78.
- ↑ 3.0 3.1 Macnab I. Cervical spondylosis. Clin Orthop Relat Res. 1975;(109):69-77.
- ↑ 4.0 4.1 Emery SE. Cervical spondylotic myelopathy: diagnosis and treatment. J Am Acad Orthop Surg. Nov-Dec 2001;9(6):376-88.
- ↑ 5.0 5.1 McCormack BM, Weinstein PR. Cervical spondylosis. An update. West J Med. Jul-Aug 1996;165(1-2):43-51.
- ↑ 6.0 6.1 Rahim KA, Stambough JL. Radiographic evaluation of the degenerative cervical spine. Orthop Clin North Am. Jul 1992;23(3):395-403.
- ↑ Ellenberg MR, Honet JC, Treanor WJ. Cervical radiculopathy. Arch Phys Med Rehabil. Mar 1994;75(3):342-52.
- ↑ 8.0 8.1 Heller JG. The syndromes of degenerative cervical disease. Orthop Clin North Am. Jul 1992;23(3):381-94.
- ↑ Kaye JJ, Dunn AW. Cervical spondylotic dysphagia. South Med J. May 1977;70(5):613-4.
- ↑ Kanbay M, Selcuk H, Yilmaz U. Dysphagia caused by cervical osteophytes: a rare case. J Am Geriatr Soc. Jul 2006;54(7):1147-8.
