CLINICAL FEATURES OF CERVICAL SPONDYLOSIS
Age 60-70 years.
CERVICAL SPONDYLOSIS …| The disc may show herniation laterally or dorsomedially. C6 C7 and C roots are commonly affected. When there is lateral herniation C7 root is commonly involved. Patient complains of pain in the neck radiating down the arms. It is increased after coughing, sneezing, jolting, etc. and is distributed in relation to the myotome and dermatome of the root involved which are given below.
There is restricted movement of the neck and in some cases fasciculation may be seen. Rarely there may be dysphagia. When there is central cervical disc protrusion there is compression of the spinal cord which may give rise to spasticity of the limbs, particularly the lower limbs with brisk jerks and extensor plantar reflex. Sensory loss due to
involvement of spinothalamic tract and sometimes of posterior column may be seen. Vertigo may be present. Disc protraction takes place at C4/5, C5/6 or at C67 level.
INVESTIGATIONS OF CERVICAL SPONDYLOSIS
1. X-ray of the cervical spine may show osteoarthritic changes with diminution of disc spaces, formation of osteophytes, and calcification at various places.
2. Myelography may help to confirm the diagnosis. Discography is also helpful.
3. MRI is the very important investigation if available.
Cervical spondylosis should be differentiated from spinal cord tumour, chronic motor neurone disease, multiple sclerosis, syringomyelia, subacute combined degeneration of the spinal cord and syphilitic amyotrophy.
Rest in bed should be enforced particularly when pain is severe. Analgesics should be prescribed if no contraindication exists. Traction of the neck followed by immobilisation on a plastic collar may be done. If there is cord compression surgery may be required.
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