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