SPONDYLOSIS
- Cervical spondylosis is the most common progressive disease in the ageing cervical spine. Seen in 95% of the people by 65 years. It can present with neck or hand pain, weakness in the hand or fingers. Severe compression on the spinal cord due to a disc prolapse can give rise to myelopathic features which can cause leg weakness and imbalance while walking.
- Evaluation of a patient involves a thorough clinical examination, MR imaging of the cervical (neck) spine.
- Management approaches to cervical disc problems involves pain medications, isometric neck exercises, physiotherapy as part of conservative management
- Surgery is advised in case of progressive symptoms which do not remit with conservative treatment, hand weakness, severe spinal cord compression.
- The type of surgery is decided based on the clinical findings in the patient which are correlated with MR imaging findings.
Low back-ache
- symptom of Lumbar disc herniation: acute or gradual
- after trauma or without an inciting event
- most common 3rd and 4th decade
Chief Complaints
- Pain, radiating from the back or buttock into the leg
- Numbness and weakness
- Sharp, lancinating, shooting/radiating pain down the leg posteriorly below the knee
- Coughing - increase intrathecal pressure - increase pain
- Sitting position, driving - increase intra-discal pressure - increase pain
Evaluation: Involves a thorough clinical evaluation based on patient symptoms, evaluation in the form of MRI of the lower back. Severe symptoms may need further neurological tests.
Management:
- Reports indicate that 40-50% of patients are symptom-free within 1 week
- Initial treatment of lumbar disc disease with pain includes bed-rest, pain medications. Physiotherapy is initiated once intensity of pain reduces.
- Surgery is indicated in patient
- With increasing, unremitting pain even after prolonged treatment.
- Leg weakness
- Symptoms of bladder or bowel involvement