Sunday, August 28, 2011

Cervical Spondylosis

Spondylosis is a term referring to degenerative osteoarthritis of the joints between the centra of the spinal vertebrae and/or neural foraminae. In this condition the facet joints are not involved. If severe, it may cause pressure on nerve roots with subsequent sensory and/or motor disturbances, such as pain, paresthesia, or muscle weakness in the limbs.
Cervical spondylosis is a disorder in which there is abnormal wear on the cartilage and bones of the neck (cervical vertebrae).

Causes, incidence, and risk factors
Cervical spondylosis is caused by chronic wearing away (degeneration) of the cervical spine, including the cushions between the neck vertebrae (cervical disks) and the joints between the bones of the cervical spine. There may be abnormal growths or "spurs" on the bones of the spine (vertebrae).
These changes can, over time, press down on (compress) one or more of the nerve roots. In advanced cases, the spinal cord becomes involved. This can affect not just the arms, but the legs as well.

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:

·         Past neck injury (often several years before)
·         Severe arthritis
·         Past spine surgery Repetitive strain injury_Caused due to lifestyle without ergonomic care, e.g., while working in front of computers, driving, traveling etc. Simple reasons like "using a blunt knife for everyday chopping of vegetables", could cause RSI.

Symptoms
Symptoms often develop slowly over time, but may start suddenly.
More common symptoms are:
·    Neck pain (may radiate to the arms or shoulder)
·    Neck stiffness that gets worse over time
·    Loss of sensation or abnormal sensations in the shoulders, arms, or (rarely) legs
·    Weakness of the arms or (rarely) legs
·    Headaches, particularly in the back of the head Less common symptoms are:
·         Loss of balance
·         Loss of control over the bladder or bowels (if spinal cord is compressed)

Signs and tests
Examination often shows limited ability to bend the head toward the shoulder and rotate the head.

Weakness or loss of sensation can be signs of damage to specific nerve roots or to the spinal cord. Reflexes are often reduced.

The following tests may be done:
·    CT scan or spine MRI
·    Spine or neck x-ray
·    EMG

x-ray or ct scan after dye is injected into the spinal column(myelogram)

Diagnosis

·     Spurling's test
·     Pain while coughing with neck in hyperextended position

CASE:
Mr. B.S. 55 Yr old man He came to see me on 04/03/11 with severe pain in RT shoulder and neck. He had vertigo and stiffness in shoulder< on rising arm. He could not raise the arm due to pain He was advised for X ray cervical AP, lat.
X ray report was space decreased between C3, C4 & C6 and C7 cervical spondylosis.
On 04/03/11 following medicines was prescribed.
A.     R 11
B.     Rhus Tox
C.     Ferum met
D.     Mag Mur
E.      Calc Flor  6x

Follow up on 22/03/11 with improvement in pain and movement of shoulder.
Same medicines repeated as above for one month.
He came on 25/05/11 with no pain neck, shoulder and movement of shoulder was normal.                                                                                       
Cured

 Dr. G. S. Bhatnagar
D.H.M.S. B.H.M.S.
Research officer
Sewa Mandir
Mobile: 9829978284
E-Mail: sewamandir@usa.net, drgsbhatnagar@gmail.com