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- 1. CERVICAL SPONDYLOSIS SALAMI Bashirah Adedoyin Student physiotherapist General Hospital Lagos
- 2. DEFINITION 01. PATHOPHYSIOLOGY 02. EPIDEMIOLOGY 03. ETIOLOGY 04. TABLE OF CONTENTS 05. 06. CLINICAL PRESENTATION DIAGNOSIS MANAGEMENT 07.
- 4. CERVICAL SPONDYLOSIS Cervical spondylosis is a term that encompasses a wide range of progressive degenerative changes that affect all the components of the cervical spine. It is a natural process of aging and presents in the majority of people after the fifth decade of life.
- 7. PATHOPHYSIOLOGY OF CERVICAL SPONDYLOSIS Disc dessication Fibrous nucleus pulposus Loss of annular fibre integrity Disc height loss Loss of fibre attachment to bone Progressive kyphosis Loss of water and protein, Increased keratin sulphate Loss of load bearing integrity, Diminished disc height Loss of elasticity, Decrease in size Osteophyte formation, Joint overload Ventral compression, Angular change of spine segment Vascular and neural compression
- 9. EPIDEMIOLOGY OF CERVICAL SPONDYLOSIS ● Most people with spondylotic changes of the cervical spine on radiographic imaging remain asymptomatic, with 25% of individuals under the age of 40, 50% of individuals over the age of 40, and 85% of individuals over the age of 60 showing some evidence of degenerative changes. ● The most frequently affected levels are C6-C7, followed by C5-C6. ● Symptomatic cervical spondylosis most commonly presents as neck pain.
- 10. EPIDEMIOLOGY OF CERVICAL SPONDYLOSIS ● A study carried out in southwest Nigeria reported that the prevalence of cervical spondylosis was 10.7% with a male to female ratio of 1.8:1.
- 11. ETIOLOGY 04.
- 12. ETIOLOGY OF CERVICAL SPONDYLOSIS ● The primary risk contributor to the incidence of cervical spondylosis is age-related degeneration of the intervertebral disc and cervical spinal elements. ● Factors that can contribute to an accelerated disease process and early-onset cervical spondylosis include: ○ exposure to significant spinal trauma ○ congenitally narrow vertebral canal ○ dystonic cerebral palsy affecting cervical musculature ○ specific athletic activities like rugby, football, and horse riding.
- 14. CLINICAL PRESENTATION ● Classically, symptomatic cervical spondylosis presents as one or more of the following three primary clinical syndromes: ○ Axial neck pain ○ Cervical radiculopathy ○ Cervical myelopathy
- 15. DIAGNOSIS 06.
- 16. DIAGNOSIS ● Cervical spondylosis is often diagnosed on clinical signs and symptoms alone. ● Most patients do not need further investigation and the diagnosis is made on clinical grounds alone however, diagnostic imaging such as X-ray, CT, MRI, and EMG can be used to confirm a diagnosis.
- 18. SPECIAL TESTS ● Spurling’s test ● Distraction test
- 19. MANAGEMENT 07.
- 20. MANAGEMENT OF CERVICAL SPONDYLOSIS ● Non-surgical ○ Pharmacological ■ NSAIDs, oral steroids, muscle relaxants, anticonvulsants, opioid analgesics ○ Physiotherapy ● Surgical
- 21. PHYSIOTHERAPY MANAGEMENT The goal of treatment is to relieve pain and prevent permanent injury to the spinal cord and nerves. This can be achieved by ● Immobilization (soft cervical collar, Philadelphia collar, Minerva body jacket) ● Exercises (Isometric, neck rotation, shoulder rotation) ● Mechanical traction ● Manual therapy ● Postural education
- 24. CORRECT POSTURE
- 25. THANK YOU!
- 26. REFERENCES • Ferrara, L.A. (2012). The Biomechanics of Cervical Spondylosis. Advances in Orthopedics, 2012, pp.1–5. • Kuo, D.T. and Tadi, P. (2020). Cervical Spondylosis. [online] PubMed. Available at: https://www.ncbi.nlm.nih.gov/books/NBK551557/. • Oguntona, S. (2014). Cervical spondylosis in South West Nigerian farmers and female traders. Annals of African Medicine, 13(2), p.61.
- 27. CREDITS: This presentation template was created by Slidesgo, including icons by Flaticon and infographics & images by Freepik
Editor's Notes
- Cervical spondylosis is a term that encompasses a wide range of progressive degenerative changes that affect all the components of the cervical spine (i.e., intervertebral discs, facet joints, joints of Luschka; OTHERWISE CALLED UNCOVERTEBRAL JOINTS, ligamenta flava, and laminae). It is a natural process of aging and presents in the majority of people after the fifth decade of life.
- Signs: Poorly localised tenderness Limited range of motion Minor neurological changes (unless complicated by myelopathy or radiculopathy) Symptoms: Cervical pain aggravated by movement Referred pain (occiput, between the shoulder blades, upper limbs) Retro-orbital or temporal pain Cervical stiffness Vague numbness, tingling or weakness in upper limbs Dizziness or vertigo Poor balance Rarely, syncope, triggers migraine
- Signs: Poorly localised tenderness Limited range of motion Minor neurological changes (unless complicated by myelopathy or radiculopathy) Symptoms: Cervical pain aggravated by movement Referred pain (occiput, between the shoulder blades, upper limbs) Retro-orbital or temporal pain Cervical stiffness Vague numbness, tingling or weakness in upper limbs Dizziness or vertigo Poor balance Rarely, syncope, triggers migraine