CERVICAL SPONDYLITIS

CERVICAL SPONDYLOSIS/ SPONDYLITIS

• Spondylitis suggests inflammation of intervertebral joints. However, the term commonly refers to degenerative disorder of cervical spine, where intervertebral disc degenerates with changes in adjacent bones and ligaments, which eventually leads to formation of protruding bar-like structures at intervertebral areas. They may protrude and compromise spinal canal or intervertebral foramen. Maximum changes occur at CS-C6, C6-C7 and C4-CS intervertebral disc spaces in that order.

Clinical Features

• Bars or protrusions may just produce localised neck pain or cause neurological problems. Neurological problems present as one or both of the following:

a. Radiculopathy       b. Myelopathy

 

Radiculopathy

• Common roots affected are CS, C6 and C7. It results in root pain with neurological deficit. Radiculopathy is a feature of dorsolateral protrusions. Onset is usually acute or may occasionally be chronic. Neck movements worsen pain.

 

Myelopathy

• Occurs when protrusions (bars) occur dorsomedially.

• Insidious onset with variable progression.

• Usually painless.

• Acute worsening may follow trauma.

• Pyramidal disturbance with impaired joint position sense (with positive Romberg's sign) is seen in lower limbs.

• Upper limbs get involved later in various combinations of upper and lower motor neuron lesions depending on the level of compression (C4, CS, C6 or C7). Multiple levels maybe evident.

• Bladder gets involved later.

 

Investigations

• Plain radiograph of cervical spine shows reduced intervertebral spaces with bony protrusions (degenerative changes).

• Myelogram clearly demonstrates the level of lesion (rarely done at present).

• CT scan or MRI can demonstrate the disordered (bony) anatomy and precise level of cord compression.

 

Management

•   Conservative management is preferred when no neurological deficit is seen. It includes rest, intermittent cervical traction and cervical collar followed by tonic neck exercises.

 

TREATMENT AT DR. SOHAN LAL CLINIC

The integrated POLYCLINIC facility offers patients to select their treatment either from the Department of Homeopathy or from the Department of Medicine.

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