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Cervical Spine Disease


Presentation

  • Further, subtle clinical presentations can belie serious myelopathy because peripheral joint involvement can make interpreting the physical exam difficult.[ncbi.nlm.nih.gov]
  • RESULTS: Patients most frequently present with hyperreflexia (21%) and weakness (21%), and there were various conservative treatment strategies.[ncbi.nlm.nih.gov]
  • The pathogenesis of DCSD is presented first with an emphasis placed on the pathological processes leading to myelopathy development.[ncbi.nlm.nih.gov]
  • Abstract A 59-year-old woman with long-standing active rheumatoid arthritis presented with posterior circulation ischemic stroke after vertebral dissection. She had severe multilevel degenerative changes of her cervical spine.[ncbi.nlm.nih.gov]
  • Four cases of dysphagia associated with disease of the cervical spine have been presented. One of the patients had cervical spondylosis with osteophyte formation while the other three had Forestier's disease or ankylosing hyperostosis.[ncbi.nlm.nih.gov]
Pain
  • PakalaS@hss.edu Abstract The use of interscalene blocks (ISBs) for shoulder surgery improves postoperative pain control, reduces recovery room times, and reduces overall hospital stays.[ncbi.nlm.nih.gov]
  • It is now generally accepted in medicine that back pain accounts for the majority of visits to the physicians’ office on a given day and, second to back pain visits, are visits for painful symptoms associated with the cervical or neck region.[practicalpainmanagement.com]
  • […] types of non-surgical care to manage the pain.[spine-health.com]
  • If the pain radiates down the arm or up the back of the head, this is not disc or facet pain but nerve pain and can occur in conjunction with neck pain.[neckandback.com]
  • Any patient suffering from neck, shoulder, head or arm pain should be examined by a doctor in order to determine where the pain originates and what is causing the pain.[sites.google.com]
Arm Pain
  • In the neck or cervical spine, radiculopathy usually is characterized by neck pain with associated shoulder blade or arm pain.[dallasneurosurgical.com]
  • This results in a pattern of arm pain (specific to the nerve root involved) along with mild weakness and sensory loss in muscles and skin innervated by that nerve root.[bestpractice.bmj.com]
  • Although complications are fairly rare, as with any surgery, the following risks may be associated with cervical spine surgery: Infection Excessive bleeding, which may require blood transfusion An adverse reaction to anesthesia Chronic neck or arm pain[aans.org]
  • A study out of Emery University noted that more than 70% of individuals without neck or arm pain had degenerative changes in their discs. These people had no symptoms.[neckandback.com]
Short Stature
  • stature (dwarfism) Abnormal growth of arms and legs Hand and foot anomalies Vision and hearing impairments Skin abnormalities Delayed or accelerated development and growth Intellectual and/or cognitive disabilities Some conditions may be diagnosed prenatally[chop.edu]
Cutaneous Manifestation
  • The role of gabapentin in treating diseases with cutaneous manifestations and pain. Int J Dermatol . 2003;42(6):491-49512786883 PubMed Google Scholar Crossref 9. Yesudian PD, Wilson NJ.[jamanetwork.com]
Alopecia
  • The differential diagnosis for scalp pruritus includes many common dermatologic conditions, including seborrheic dermatitis, psoriasis, scarring alopecia, tinea capitis, pediculosis, contact dermatitis, allergic dermatitis, acne, and folliculitis.[jamanetwork.com]
Excoriation
  • The physical examinations were unremarkable for primary lesions, although 3 patients had secondary excoriations in the symptomatic areas of their scalps.[jamanetwork.com]
Neck Pain
  • These movable areas can wear out and cause neck pain. The neck pain from the wear of these structures may be located in the center of the neck, the side of the neck and also may radiate into the top or middle of the shoulders.[neckandback.com]
  • Most non-surgical treatment programs for neck pain will include some form of exercise and stretching.[spine-health.com]
  • The common causes of neck pain and cervical disorders include arthritis, injuries, and trauma. In some situations neck pain can also be a warning sign of something more serious such as spinal cord compression, a tumor or spinal infection.[sites.google.com]
  • A hot/cold therapy and gentle massage can also be beneficial for neck pain. Chiropractic care may also be considered at this time.[princetonbrainandspine.com]
  • You should consult a neurosurgeon for neck pain if It occurs after an injury or blow to the head Fever or headache accompanies the neck pain Stiff neck prevents touching chin to chest Pain shoots down one arm There is tingling, numbness or weakness in[aans.org]
Spine Pain
  • What Cervical Spine Pain Could Mean Neck pain can be debilitating and there is a wide range of possible causes.[centerforneuroandspine.com]
  • Garvey T, Transfeldt E, Malcolm J, et al: Outcome of anterior cervical discectomy and fusion as perceived by patients treated for dominant axial-mechanical cervical spine pain. Spine 2002;27:1887. Gore DR, Sepic SB.[uscspine.com]
  • Treatment and Prevention of Muscular/Ligamentous Syndromes and Degenerative Joint and Disc Disease of the Cervical Spine Self Treatment: Rest, massage and ice or heat are certainly the first step in treating the acute onset of cervical spine pain, particularly[minneapolisclinic.com]
  • Other passive treatments such as massage, ultrasound and iontopheresis have not been shown to be effective in patients with cervical spine pain [ 16 ].[ncbi.nlm.nih.gov]
Cervical Osteoarthritis
  • It’s also known as cervical osteoarthritis or neck arthritis. It develops from the wear and tear of cartilage and bones. While it’s largely the result of age , it can be caused by other factors as well.[healthline.com]
  • It is worth repeating, for emphasis, the fact that NOT ALL NECK AND ARM PAIN IS DUE TO A HERNIATED DISC, CERVICAL OSTEOARTHRITIS OR NERVE ROOT COMPRESSION.[neurosurgerydallas.com]
Skeletal Dysplasia
  • PURPOSE: Chondrodysplasia punctata (CDP) is a group of skeletal dysplasias manifesting with progressive cervical instability that leads to neurological deficits and eventual death.[ncbi.nlm.nih.gov]
Chest Deformity
  • deformity Misshapen, fused or absent ribs Breathing difficulties Short stature (dwarfism) Abnormal growth of arms and legs Hand and foot anomalies Vision and hearing impairments Skin abnormalities Delayed or accelerated development and growth Intellectual[chop.edu]
Hyperreflexia
  • RESULTS: Patients most frequently present with hyperreflexia (21%) and weakness (21%), and there were various conservative treatment strategies.[ncbi.nlm.nih.gov]
  • Upper motor neurone signs in the lower limbs (Babinski's sign - up-going plantar reflex, hyperreflexia, clonus, spasticity). Lower motor neurone signs in the upper limbs (atrophy, hyporeflexia).[patient.info]
  • A characteristic physical finding of CSM is hyperreflexia. The biceps and supinator reflexes (C5 and C6) may be absent, with a brisk triceps reflex (C7).[aafp.org]
  • . - neck pain, decrease ROM, crepitation, and occipital HA are common sx; - neurologic impairment in pts w/ RA usually occurs very gradually and may cause decreased pain sensation and hyperreflexia early; - Radiographic Work Up; - Cross Table Lateral[wheelessonline.com]
  • […] impingement is less forgiving than lumbar nerve impingement Prolonged impingement with neurologic deficits is a risk for persistent deficits Cervical Spinal Stenosis may result in significant spinal cord injury Upper Motor Neuron effects may include hyperreflexia[fpnotebook.com]
Paresthesia
  • Symptoms Neck tight or stiff Radicular Symptoms Characteristics Radicular pain (most common) Paresthesia s Weakness (15% of patients) Radiation into Shoulder Radiation along Radial Nerve distribution into arm Does not often radiate below elbow Contrast[fpnotebook.com]
  • […] and colleagues described 2 case reports in which intrinsic spinal cord damage resulted from cervical epidural steroid injection despite fluoroscopic guidance; the patients, because of intravenous sedation, were unable to perceive and report pain and paresthesias[emedicine.medscape.com]
Hyporeflexia
  • Lower motor neurone signs in the upper limbs (atrophy, hyporeflexia). Variable sensory changes (loss of vibration and joint position sense more evident in the hands than in the feet).[patient.info]
Dystonia
  • Patients with cervical dystonia or tics of the nuchal muscles can develop serious cervical spine disease.[ncbi.nlm.nih.gov]
Numbness in the Buttocks

Workup

  • In addition, consider performing infection workup to evaluate for possible discitis, epidural abscess, and vertebral osteomyelitis.[emedicine.medscape.com]
  • Radiological examination included the following workup as we reported previously. 6 , 7 (i) Lordotic alignment of the cervical spine on radiographs taken in neutral positions, designated as cervical spine lordosis.[nature.com]

Treatment

  • There were two deaths reported, one resulting from conservative treatment and one from surgical treatment.[ncbi.nlm.nih.gov]
  • While the radiographic features can be dramatic in untreated disease, patients may remain asymptomatic making treatment decisions challenging.[ncbi.nlm.nih.gov]
  • BACKGROUND: The efficacy of anterior fusion using zero-profile implant (Zero-P) in the surgical treatment of degenerative cervical disease was investigated through radiographic and clinical comparisons with existing treatments using autograft or allograft[ncbi.nlm.nih.gov]
  • Treatments include medication, physical therapy and surgery.[wexnermedical.osu.edu]
  • Treatment options Non-surgical treatment often helps to relieve pain and symptoms. Your doctor may combine two or more therapies to maximize the success of your treatment.[spinesurgery.com]

Prognosis

  • Use of proper mechanics, proper posture, body mechanics and awareness of the do’s and don’ts for a healthy back is necessary for a good long-term prognosis.[twinboro.com]
  • The nature of their genetic condition and any other health issues, how quickly the child is diagnosed, and possible treatment options, all factor into a child’s long-term prognosis.[chop.edu]
  • […] joint ankylosis enthesopathy of the iliac crest, ischial tuberosities, and greater trochanters and spur formation in the appendicular skeleton (olecranon, calcaneum, patellar ligament) are frequently present 'whiskering' enthesophytes Treatment and prognosis[radiopaedia.org]
  • Treatment and prognosis of cervical radiculopathy. . Accessed May 8, 2018. Shelerud RA (expert opinion). Mayo Clinic, Rochester, Minn. May 10, 2018.[mayoclinic.org]

Etiology

  • Background & Etiology The neck, or cervical spine, can be divided into three separate areas each performing a slightly different function.[twinboro.com]
  • The etiology of DISH is still unknown.[radiopaedia.org]
  • Causes There are a number of specific causes of degenerative disc disease, ranging from an initial injury to the annulus (outer ring of the disc), facet joint injury, fractures, infections or rheumatologic etiologies (causes).[uscspine.com]
  • Brodsky 14 reported the largest series of 438 cases with cervical angina, and perhaps had made the finest insight into the physiological etiologies.[nature.com]

Epidemiology

  • Over the past 50 years, we have found a significant decrease in the prevalence of aAAS, possibly due to improved disease control with modern DMARDs or changing epidemiology of RA.[arthritis-research.biomedcentral.com]
  • Incidence and epidemiology of cervical radiculopathy in the United States military: 2000 to 2009. J Spinal Disord Tech. 2012 Feb. 25(1):17-22. [Medline]. Salemi G, Savettieri G, Meneghini F, et al.[emedicine.medscape.com]
  • Incidence and epidemiology of cervical radiculopathy in the United States military: 2000 to 2009. J Spinal Disord Tech . 2012 Feb. 25(1):17-22. [Medline] . Salemi G, Savettieri G, Meneghini F, et al.[emedicine.medscape.com]
  • Epidemiology Incidence (U.S.) Men: 107 per 100,000/year Women: 64 per 100,000/year C5-C6 disc represents 90% of cervical disc lesions C6 nerve root impingement is most common (followed by C7 nerve root impingement) IV.[fpnotebook.com]
Sex distribution
Age distribution

Pathophysiology

  • An understanding of the pathophysiological background of DCSD is necessary for appropriate interpretation of MR images, both plain and DTI.[ncbi.nlm.nih.gov]
  • Introduction: Most of these cutaneous pain symptoms are not attributed to any pathophysiology. The range of complaints vary widely from tingling, stinging to severe itching leading to scratch-itch cycle.[journalijdr.com]
  • A review of the pathophysiology of cervical spondylotic myelopathy with insights for potential novel mechanisms drawn from traumatic spinal cord injury. Spine . 1998;23:2730–7. 3. Wilkinson M.[aafp.org]
  • Current understanding of lumbar intervertebral disc degeneration: a review with emphasis upon etiology, pathophysiology, and lumbar magnetic resonance imaging findings. fckLRJOSPT 2008; 38(6):329-340 (level of evidence 1b) Zhang Y.[physio-pedia.com]
  • Current understanding of lumbar intervertebral disc degeneration: a review with emphasis upon etiology, pathophysiology, and lumbar magnetic resonance imaging findings. J Orthop Sports Phys Ther. 2008;38:329–340. Free Article.[moveforwardpt.com]

Prevention

  • CONCLUSIONS: This study emphasizes the need for careful neurological and surgical evaluation of pediatric patients with cervical spine abnormalities affected by CDP or CE in order to prevent progressive instability.[ncbi.nlm.nih.gov]
  • Ohio State’s stroke program is improving health care by developing the next breakthroughs in stroke prevention, diagnosis and care.[wexnermedical.osu.edu]
  • Physical therapy is recommended to develop a series of stretching and strengthening exercises to prevent reoccurrence of the injury. Return to activity should be gradual to prevent a flare up of symptoms.[twinboro.com]
  • If you’re already suffering from degenerative disc disease, it’s important to seek treatment or begin home remedies to prevent it from getting worse. Degenerative disc disease is a progressive condition that typically develops in older demographics.[neuromicrospine.com]

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