Spondylosis

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Lumbar Spondylosis

This is a degenerative disorder of the lumbar spine charecterised  clinically by an insidous onset of pain stiffness, radiologically by osteophyte formation.

Causes

Bad posture & chronic back strain is the commonest  cause .Other causes being previous injury to the spine , previous diseases of the spine, birth defects & old intervertebraldisc prolapse.

Diagnosis

Clinical features- The symptoms begin as low back ache initially worst during activity,but later present almost all the time .There may be a feeling of a catch while getting up from a sitting position which improves as one walks few steps.

The pain may radiate down the limb upto the calf(sciatica) because of irritation of one of the nerve roots.

The spinal movements are limited terminally, but there is little muscle spasm

The straight leg raisingtest(SLRT) may be positive if the nerve root compression is present.

Radiological findings include reduction on disc spsce,osteophyte formation, narrowing of joint space of the facet joints,subluxation of one vertebra over another.

CERVICAL SPONDYLOSIS

Cervical spondilitis is a degenerative condition of the cervical spine found almost universally in persons over 50yrs of age.

It occurs mostly in those susceptable to neck strain because of keeping the neck constantly in one position while reading, writing etc

Degeneration of disc results in reduction of disc space & peripheral osteophyte formation.The osteophytes impinging on the nerve roots give rise to radicular pain in the upperlimb.CS occurs  most commonly in the lowest cervical intervertebral  joints.

Diagnosis

Pain & stiffness- This is the commonest presenting symptom initially intermittent but later persistent.

Occipital headache may occur if the upper half of the cervical spine is affected.

Radiating pain-The patient may present with pain radiating to the shoulder or downward on the outer aspect of the forearm & hand.There may be parasthesia in the region of the nerve root commonly  over the base of the thumb.

Giddiness—The patient may present with an episode of giddiness because of vertebro basilar syndrome.

Radiological examination-X rays of the cervical spine(anterioposterior,lateral) are sufficient in most cases.

Narrowing of the intervertebral disc spaces.Osteophytes at the vertebral margins anteriorly & posteriorly.Narrowing of the intervertebral foramen in cases presenting with radicular symptoms.

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