What treatment should a person with Cervical Spondylosis do?

Clinical Features And Management of Cervical Spondylosis:

The mobile cervical spine is particularly subject to osteoarthritis change and this occurs in more than half the population over 50 years of ages: of these approximately 20% develop symptoms. Relatively few require operative treatment.

Resultant damage to the spinal cord may arise from direct pressure or may follow vascular impairment. The onset is usually gradual. Trauma may or may not predispose to the development of symptoms.

CLINICAL FEATURES

RadicuIopathy:

Pain: A sharp stabbing pain, worse on coughing, may be superimposed on a more constant deep ache radiating over the shoulders and down the arm.

Paraesthesia: Numbness or tingling follows a nerve root distribution.

Root Signs:

• Sensory loss, i.e. pin prick deficit in the appropriate dermatomal distribution.
• Muscle (I.m.n.) weakness and wasting in appropriate muscle groups.
• Reflex Impairment / lossC5, 6….. Biceps, supinator jerk: C7……. triceps jerk.
• Trophic Change: In long-standing root compression, skin becomes dry, scaly, inelastic, blue and cold.

Arms: l.m.n. signs and symptoms, as above, at the level of the lesion and/or u.m.n. signs and symptoms below the level of the lesion, e.g. CS lesion: deltoid and biceps weakness and wasting; reduced biceps reflex; increased finger reflex. C3/4 lesions produce syndrome of numb clumsy hands (reflecting posterior column loss).

Legs: u.m.n. signs and symptoms, i.e. difficulty in walking due to stiffness; ‘pyramidal‘ distribution weakness, increased tone, clonus and extensor plantar responses; sensory symptoms and signs are variable and less prominent.

Sphincter disturbance is seldom a prominent early feature.

INVESTIGATION

Plain X-ray of Cervical Spine

Look For:

• Congenital narrowing of canal, loss of lordosis.
• Disc space narrowing and osteophyte protrusion (foraminal encroachment is best seen in oblique views).
• Subluxation Flexion/extension views may be required.

MRI: The investigation of choice. Sagittal views clearly demonstrate cord compression at the level of the disc space. Any hyper intensity within the cord on T2 weighting reflects cord damage and may correlate with the severity of the myelopathy and outcome. Axial views show cord compression and the degree of foraminal narrowing.

MANAGEMENT

1. Conservative

Analgesics/Cervical collar:  Symptoms of radiculopathy, whether acute or chronic, usually respond to these conservative measures plus reassurance. Progression of a disabling neurological deficit however demands surgical intervention. The clinician may adopt a conservative approach when a myelopathy is mild, but undue delay in operation may reduce the chance of recovery.

2. Indications for Operations:

• Progressive neurological deficit- myelopathy or radiculopathy.
• Intractable pain, when this fails to respond to conservative measures. This is rarely the sole indication for operation and usually applies to acute disc protrusion rather than chronic radiculopathy.

3. Operative Techniques:

(a)  Anterior Decompression and Fusion:

A core of bone and disc is removed along with the osteophyric projections. Although not essential, some insert a bone graft from the iliac crest, or a metallic cage to promote fusion. More recently prosthetic discs have become available. There is no evidence that any one technique produces better results than another.

 (b)  Posterior Approach:

Most suitable for root or cord compression from an anterior protrusion at one or two levels.

• Laminectomy: A wide decompression, usually from C3-C7, is carried out. Appropriate for multilevel cord compression especially if superimposed on a congenitally narrow spinal canal.
• Foraminaotomy: The nerve root at one or more levels may be decompressed by drilling awaver lying bone.

Results

Operative results vary widely in different series and probably depend on patient selection. Some improvement occurs in 50-80% of patients. Operation should be preventing progression rather than curing all symptoms.

If you are being affected by this serious disease Cervical Spondylosis. Braner Pain Clinics specialize in chronic pain management, neurology, neurological testing and disability.

You should call us if you have been advised to learn to live with pain; or have been denied compensation due to an injury for lack of medical evidence. For More Information Call Now at: 1 (877) 573-1282 

http://www.branerpainclinic.com

How we cure Spinal Cord Pain Disease?

Causes , Symptoms and Clinical Features of Spinal Cord Compression:

Disorders localized to the spinal cord or nerve roots are detailed below, but note that many diffuse neurological disease processes also affect the cord.

SPINAL CORD AND ROOT COMPRESSION

As the spinal canal is a rigidly enclosed cavity, an expanding disease process will eventually cause cord and/or root compression.

CAUSES:

Tumours

• Primary
• Secondary

Infection

• Acute
• Chronic

Disc Disease And Spondylosis

• Haematoma
• Cystic Lesions

Manifestations of cord or root compression depend upon the following:

1. Site of lesion within the spinal canal: An expanding lesion outside the cord produces signs and symptoms from root and segmental damage.

• ROOT: Lower motor neuron (l.m.n.) and sensory impairment appropriate to the distribution of the damaged root.
• SEGMENTAL: l.m.n. and sensory impairment appropriate to segmental level. Interruption of ascending sensory and descending motor tracts produces sensory impairment and an upper motor neuron (u.m.n.) deficit below the level of the lesion. Lesions within the cord (intramedullary) produce segmental signs and symptoms.

2. Level of the Lesion: A lesion above the LI vertebral body may damage both the cord and its roots. Below this, only roots are damaged.

3. Vascular involvement: Neuronal damage from mechanical stretching is of less importance than the vascular effects. At first venous obstruction leads to vasogenic oedema, but eventually impaired arterial flow causes irreversible spinal cord infarction. Clinical findings may suggest cord damage well beyond the level of compression, implying a distant ischaemic effect from vessel compromise at the lesion site.

4. Speed of onset:  Speed of compression affects the clinical picture. Despite producing upper motor neuron damage, a rapidly progressive cord lesion often produces a ‘flaccid paralysis‘ with loss of reflexes and absent plantar responses. This state is akin to spinal shock seen following trauma. Several days or weeks may elapse before tone returns accompanied by the expected  ‘upper motor neuron signs.

CLINICAL FEATURES:

These depend on the site and level of the compressive lesion.

• ROOT: Severe, sharp, shooting, burning pain radiating into the cutaneous distribution or muscle group supplied by the root; aggravated by movement, straining or coughing.
• SEGMENTAL: Continuous, deep aching pain radiating into whole leg or one half of body; not affected by movement.
• BONE: Continuous, dull pain and tenderness over the affected area; may or may not be aggravated by movement.

If you think you may be suffering from discomfort due to nerve root compression, visit your doctor now. In most circumstances, minimal discomfort can be handled through traditional treatments required by your doctor, such as treatment, physical rehabilitation, or massage therapy.Contact the experienced team of neurological specialists at Braner Pain Clinic to learn more about our clinic Contact us at: 1 (877) 573-1282

http://www.branerpainclinic.com/