Cervical Stenosis: Difference between revisions
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== Characteristics/Clinical Presentation == | == Characteristics/Clinical Presentation == | ||
Cervical stenosis does not necessarily cause symptoms, but if symptoms are present they will mainly be caused by cervical radiculopathy or myelopathy. <br> | Cervical stenosis does not necessarily cause symptoms, but if symptoms are present they will mainly be caused by cervical radiculopathy or myelopathy. <br> | ||
The symptoms are:<ref>North Amercian Spine Society, Cervical Stenosis, http://www.spine.org/Documents/cervical_stenosis_2006.pdf (accesed 22 november 2011)</ref><ref>Williams S.K. et al, Concomitant Cervical and Lumbar Stenosis: Strategies for Treatment and Outcomes, Semin Spine Surg, 2007 Sep, volume 19 issue 3: 165-176. (Level of Evidence 2A)</ref><ref>Countee R.W. et al, Congenital Stenosis of the Cervical Spine: Diagnosis and Management , J Natl Med Assoc, 1979 March, Volume 71, Issue 3, 257-264 (Level of Evidence 2B)</ref> | The symptoms are:<ref>North Amercian Spine Society, Cervical Stenosis, http://www.spine.org/Documents/cervical_stenosis_2006.pdf (accesed 22 november 2011)</ref><ref>Williams S.K. et al, Concomitant Cervical and Lumbar Stenosis: Strategies for Treatment and Outcomes, Semin Spine Surg, 2007 Sep, volume 19 issue 3: 165-176. (Level of Evidence 2A)</ref><ref>Countee R.W. et al, Congenital Stenosis of the Cervical Spine: Diagnosis and Management , J Natl Med Assoc, 1979 March, Volume 71, Issue 3, 257-264 (Level of Evidence 2B)</ref> | ||
*Pain in neck or arms<br> | *Pain in neck or arms<br> | ||
*Arm and leg dysfunction<br> | *Arm and leg dysfunction<br> | ||
*Weakness, stiffness or clumsiness in the hands<br> | *Weakness, stiffness or clumsiness in the hands<br> | ||
*Leg weakness<br> | *Leg weakness<br> | ||
*Difficulty walking<br> | *Difficulty walking<br> | ||
*Frequent falling<br> | *Frequent falling<br> | ||
*The need to use a cane or walker<br> | *The need to use a cane or walker<br> | ||
*Urinary urgency which may result in later cases in bladder and bowel incontinence<br> | *Urinary urgency which may result in later cases in bladder and bowel incontinence<br> | ||
*Diminished proprioception | *Diminished proprioception | ||
<br> | <br> | ||
The progression of the symptoms may also vary: | The progression of the symptoms may also vary: | ||
*A slow and steady decline | *A slow and steady decline | ||
*Progression to a certain point and stabilizing | *Progression to a certain point and stabilizing | ||
*Rapidly declining <br> | *Rapidly declining <br> | ||
<br> | |||
== Differential Diagnosis == | == Differential Diagnosis == | ||
| Line 52: | Line 52: | ||
== Diagnostic Procedures == | == Diagnostic Procedures == | ||
Physical examination: <ref>North Amercian Spine Society, Cervical Stenosis, http://www.spine.org/Documents/cervical_stenosis_2006.pdf (accesed 22 november 2011)</ref><ref name="Williams">Williams S.K. et al, Concomitant Cervical and Lumbar Stenosis: Strategies for Treatment and Outcomes, Semin Spine Surg, 2007 Sep, volume 19 issue 3: 165-176. (Level of Evidence 2A)</ref><ref name="Countee">Countee R.W. et al, Congenital Stenosis of the Cervical Spine: Diagnosis and Management , J Natl Med Assoc, 1979 March, Volume 71, Issue 3, 257-264 (Level of Evidence 2B)</ref><ref name="Santhosh">Santhosh A. et al., Spinal stenosis: history and physical examination, Phys Med Rehabil Clin N Am , 2003, 14,</ref> | |||
*Increased reflexes in the knee and ankle, this is called a hyperreflexia, it’s sometimes found with depressed reflexes in the arm | |||
*Changes in the gait such as clumsiness or loss of balance | |||
*Loss of sensitivity in the hand/or feet | |||
*Rapid foot beating that is triggered by turning the ankle upward. | |||
*Babinski’s sign | |||
*Hoffman’s sign | |||
X- rays of the cervical spine doesn’t provide enough information to confirm cervical stenosis, but can be used to rule out other conditions. Cervical stenosis can occur at one level or multiple levels of the spine, therefore is an MRI useful for looking at several levels at one time. It’s also useful to use MRI images because they are very detailed and show the tight spinal canal and pinching of the spinal cord. But a CT scan can give better information about the bony invasion of the canal and can be combined with myelography. <ref name="North American">North Amercian Spine Society, Cervical Stenosis, http://www.spine.org/Documents/cervical_stenosis_2006.pdf (accesed 22 november 2011)</ref><ref>Williams S.K. et al, Concomitant Cervical and Lumbar Stenosis: Strategies for Treatment and Outcomes, Semin Spine Surg, 2007 Sep, volume 19 issue 3: 165-176. (Level of Evidence 2A)</ref><br> | |||
== Outcome Measures == | == Outcome Measures == | ||
| Line 93: | Line 102: | ||
<references /> | <references /> | ||
<br> | |||
[[Category:Vrije_Universiteit_Brussel_Project|Template:VUB]] | [[Category:Vrije_Universiteit_Brussel_Project|Template:VUB]] | ||
Revision as of 12:45, 16 January 2012
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Characteristics/Clinical Presentation[edit | edit source]
Cervical stenosis does not necessarily cause symptoms, but if symptoms are present they will mainly be caused by cervical radiculopathy or myelopathy.
- Pain in neck or arms
- Arm and leg dysfunction
- Weakness, stiffness or clumsiness in the hands
- Leg weakness
- Difficulty walking
- Frequent falling
- The need to use a cane or walker
- Urinary urgency which may result in later cases in bladder and bowel incontinence
- Diminished proprioception
The progression of the symptoms may also vary:
- A slow and steady decline
- Progression to a certain point and stabilizing
- Rapidly declining
Differential Diagnosis[edit | edit source]
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Diagnostic Procedures[edit | edit source]
Physical examination: [4][5][6][7]
- Increased reflexes in the knee and ankle, this is called a hyperreflexia, it’s sometimes found with depressed reflexes in the arm
- Changes in the gait such as clumsiness or loss of balance
- Loss of sensitivity in the hand/or feet
- Rapid foot beating that is triggered by turning the ankle upward.
- Babinski’s sign
- Hoffman’s sign
X- rays of the cervical spine doesn’t provide enough information to confirm cervical stenosis, but can be used to rule out other conditions. Cervical stenosis can occur at one level or multiple levels of the spine, therefore is an MRI useful for looking at several levels at one time. It’s also useful to use MRI images because they are very detailed and show the tight spinal canal and pinching of the spinal cord. But a CT scan can give better information about the bony invasion of the canal and can be combined with myelography. [8][9]
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References[edit | edit source]
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- ↑ North Amercian Spine Society, Cervical Stenosis, http://www.spine.org/Documents/cervical_stenosis_2006.pdf (accesed 22 november 2011)
- ↑ Williams S.K. et al, Concomitant Cervical and Lumbar Stenosis: Strategies for Treatment and Outcomes, Semin Spine Surg, 2007 Sep, volume 19 issue 3: 165-176. (Level of Evidence 2A)
- ↑ Countee R.W. et al, Congenital Stenosis of the Cervical Spine: Diagnosis and Management , J Natl Med Assoc, 1979 March, Volume 71, Issue 3, 257-264 (Level of Evidence 2B)
- ↑ North Amercian Spine Society, Cervical Stenosis, http://www.spine.org/Documents/cervical_stenosis_2006.pdf (accesed 22 november 2011)
- ↑ Williams S.K. et al, Concomitant Cervical and Lumbar Stenosis: Strategies for Treatment and Outcomes, Semin Spine Surg, 2007 Sep, volume 19 issue 3: 165-176. (Level of Evidence 2A)
- ↑ Countee R.W. et al, Congenital Stenosis of the Cervical Spine: Diagnosis and Management , J Natl Med Assoc, 1979 March, Volume 71, Issue 3, 257-264 (Level of Evidence 2B)
- ↑ Santhosh A. et al., Spinal stenosis: history and physical examination, Phys Med Rehabil Clin N Am , 2003, 14,
- ↑ North Amercian Spine Society, Cervical Stenosis, http://www.spine.org/Documents/cervical_stenosis_2006.pdf (accesed 22 november 2011)
- ↑ Williams S.K. et al, Concomitant Cervical and Lumbar Stenosis: Strategies for Treatment and Outcomes, Semin Spine Surg, 2007 Sep, volume 19 issue 3: 165-176. (Level of Evidence 2A)
