Cervical Spondylosis: Causes, Incidence and Risk Factors and Physiotherapy Approach

Topics: Vertebral column, Randomized controlled trial, Epidemiology Pages: 10 (2770 words) Published: January 29, 2013
Cervical Spondylosis: Causes, incidence and risk factors and Physiotherapy approach Table of Contents:
Serial No.| Contents| Page No.|
1.| Introduction| 02|
| Background| 04|
| Justification| 05|
| | |
2.| Objective| 05|
2.1 | General objective| 05|
2.2| Specific objective| 05|
| | |
3.| Methodology| 06|
3.1| Study design| 06|
3.2| Sample size| 06|
3.3| Sampling technique| 06|
3.4| Research instrument| 06|
3.5| Study population| 06|
3.6| Place of work| 06|
3.7| Duration| 06|
3.8| Variable| 07|
3.9| Operation definition| 07|
3.10| Ethical consideration| 08|
3.11| Data analysis| 08|
| | |
4.| References| 09|

Cervical spondylosis is a common degenerative condition of the cervical spine. It encompasses a sequence of degenerative changes in the intervertebral discs, osteophytosis of the vertebral bodies, hypertrophy of the facets and laminal arches, and ligamentous and segmental instability. As spondylosis refers degenerative osteoarthritis of joint, it may cause pressure on nerve roots with subsequent sensory or motor disturbance. Clinically, several syndromes, both overlapping and distinct, are seen. These include neck and shoulder pain, sub occipital pain and headache, radicular symptoms, and cervical spondylotic myelopathy (CSM). Radiculopathy is characterized by sensory and motor disturbances, such as severe pain in the neck, shoulder, arm, back, and/or leg, accompanied by muscle weakness, whereas, less commonly, direct pressure on the spinal cord (typically in the cervical spine) may result in myelopathy, characterized by global weakness, gait dysfunction, loss of balance, and loss of bowel and/or bladder control. The patient may experience a phenomenon of shocks (paresthesia) in hands and legs due to nerve root compression. Frequently, associated degenerative changes in the facet joints, hypertrophy of the ligamentum flavum, and ossification of the posterior longitudinal ligament occur. All can contribute to impingement on pain-sensitive structures (eg, nerves, spinal cord), thus creating previously described clinical syndromes.

The natural history of cervical spondylosis is associated with the aging process. Spondylotic changes are often observed in the aging population. However, only a small percentage of patients with radiographic evidence of cervical spondylosis are symptomatic. Everyday wear and tear may start these changes. People who are very active at work or in sports may be more likely to have them. The major risk factor is aging. By age 60, most women and men show signs of cervical spondylosis on x-ray. Other factors that can make a person more likely to develop spondylosis are being overweight and not exercising, having a job that requires heavy lifting or a lot of bending and twisting, past neck injury (often several years before), past spine surgery, ruptured or slipped disk, severe arthritis, small fractures to the spine from osteoporosis.

Although pain is predominantly in the cervical region, it can be referred to a wide area, and is characteristically exacerbated by neck movement. Neurological change should always be sought in the upper and lower limbs, but objective changes occur only when spondylosis is complicated by myelopathy or radiculopathy, or when unrelated causes like disc prolapsed, thoracic outlet obstruction, brachial plexus disease, malignancy, or primary neurological disease are present.

Presenting features of cervical spondylosis are closely related to pain. Symptoms include cervical pain aggravated by movement, referred pain (occiput, between the shoulder blades, upper limbs), retro-orbital or temporal pain (from C1 to C2), cervical stiffness—reversible or irreversible, vague numbness, tingling, or weakness in upper limbs, dizziness or vertigo, poor balance and rarely, syncope, triggers migraine, “pseudo-angina” etc. Several signs can be...
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