Degenerative disease of spine

 

 

Cervical spondylosis

-                   Cause

  • Degeneration of disc, facet joint

 

-                   Clinical presentation

  • Neck pain
  • Radiculopathy
  • Myelopathy
  • Vertebrobasilar insufficiency

-                   Investigation

  • X ray
    • Osteophyte
    • Subluxation
  • MRI
    • Disc
    • Spinal cord
    • Spinal nerve root
  • EMG ,NCV

-                   Differential Diagnosis

  • nerve entrapment syndrome
  • rotation cuff lesion
  • cervical tumors
  • Thoracic outlet syndrome

-                   Treatment

  • Supportive treatment
  • Surgical treatment
    • anterior discectomy and fusion
    • foraminotomy
    • laminoplasty

 

Lumbar spondylosis

-                   Cause and and Pathology

  • Intervertebral disc degeneration
  • Facet hypertrophy
  • Ligamentum flavum hypertrophy
  • Segmental instability

-                   Clinical presentation

  • LBP
  • radiculopathy
  • neurogenic claudication

-                   Investigation

  • X ray
    • Narrow disc space
    • Marginal osteophyte
    • Facet joint osteoarthritis
    • Vertebral displacement (spondylolisthesis)
  • MRI
    • bulgingannulus fibrosus
    • Decrease disc height of intervertebral disc
    • Decrease signal intensity of intervertebral disc

Spinal stenosis

-                   Cause

  • degeneration

-                   Pathophysiology

  • Degenerated interverteral disc and facet joint

-                   Clinical presentation

  • LBP
  • radiculopathy
  • neurogenic claudication

-                   Investigation

  • X ray
  • MRI
  • Computerized Tomography
  • Melography

-                   Differential Diagnosis

  • vascular claudication

-                   Treatment

  • Conservative treatment
    • Medication
    • Life style modification
  • Operative treatment
    • Decompression

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