Spondlyosis

Spondylosis

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Not to be confused with spondylitis, spondylolysis, or spondylolisthesis.

Spondylosis

Classification and external resources

ICD-10

M47

ICD-9

721

OMIM

184300

DiseasesDB

12323

MedlinePlus

000436

eMedicine

neuro/564

MeSH

D013128

Spondylosis is a term referring to degenerative osteoarthritis of the joints between the centre of the spinal vertebrae and/or neural foraminae. If this condition occurs in the zygapophysial joints, it can be considered facet syndrome. 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.

When the space between two adjacent vertebrae narrows, compression of a nerve root emerging from the spinal cord may result in radiculopathy (sensory and motor disturbances, such as severe pain in the neck, shoulder, arm, back, and/or leg, accompanied by muscle weakness). 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 because of nerve compression and lack of blood flow. If vertebrae of the neck are involved it is labelled cervical spondylosis. Lower back spondylosis is labeled lumbar spondylosis.

Contents
[hide] 1 Causes
2 Diagnosis
3 Treatment
4 Surgery
5 Complications
6 References
7 External links

[edit] Causes
Repetitive strain injury (RSI) caused due to lifestyle without ergonomic care, e.g., while working in front of computers, driving, traveling, intense work in farm, etc.
Age related degeneration
Spondylosis will not show up on regular xrays. Regular x-rays may appear completely normal so some physicians will not suspect this as a diagnosis and may say the pain is psychosomatic. Only an MRI without contract test or higher will show this as a possible diagnosis.(Newman,Santiago 2013)
Spondylosis is not limited to a specific age group and can affect a person at any age, however, older people are more susceptible.(Newman, Santiago 2013)

[edit] Diagnosis
Spurling’s test Pain while rotating the head laterally and placing downward pressure on the head. A positive sign is neck or shoulder pain on the ipsilateral side, that is, the side to which the head is rotated.
Lhermitte sign, feeling of electrical shock with neck flexion;
reduced range of motion of the neck, the most frequent objective finding on physical examination

[edit] Treatment

Treatment is usually conservative in nature. Patient education on lifestyle modifications and nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, chiropractic manipulative therapy (CMT), and osteopathic manipulative treatment (OMT) have been shown to manage such conditions[citation needed]. Other alternative therapies such as massage, trigger-point therapy, yoga and acupuncture may be of limited benefit[citation needed]. Surgery is occasionally performed.

Many of the treatments for cervical spondylosis have not been subjected to rigorous, controlled trials.[citation needed] Surgery is advocated for cervical radiculopathy in patients who have intractable pain, progressive symptoms, or weakness that fails to improve with conservative therapy. Surgical indications for cervical spondylosis with myelopathy (CSM) remain somewhat controversial, but “most clinicians recommend operative therapy over conservative therapy for moderate-to-severe myelopathy.” (Baron, M.E.)

Physical therapy may be effective for restoring range of motion, flexibility, and core strengthening. There is no evidence for the effectiveness of osteopathic or chiropractic care. Rarely, chiropractic care to the cervical spine results in vascular emergencies like carotid artery dissection.[citation needed] Decompressive therapies (i.e. manual mobilization, mechanical traction) may also help alleviate pain. However, physical therapy and chiropractic cannot “cure” the degeneration, and some people view that strong compliance with postural modification is necessary to realize maximum benefit from decompression, adjustments, and flexibility rehabilitation.

It is often argued, however, that the cause of spondylosis is simply old age, and that posture modification treatment is often practiced by those who have a financial interest (such as Worker’s Compensation)[1] in proving that it is caused by work conditions and poor physical habits. Understanding anatomy is the key to conservative management of spondylosis.

[edit] Surgery

Many surgical procedures have been developed to alleviate the signs and symptoms associated with spondylosis. The vertebral column can be approached by the surgeon from the front, side, or rear. Osteophytes and sometimes portions of an intervertebral disc are commonly removed in an effort to relieve pressure on adjacent nerve roots and/or the spinal cord.

[edit] Complications

A major problem related to this disease is vertebrobasilar insufficiency. This is a result of the vertebral artery becoming occluded as it passes up in the transverse foramen. The spinal joints become stiff in cervical spondylosis. Thus the chondrocytes which maintain the disc become deprived of nutrition and die. The weakened disc bulges and grows out as a result of incoming osteophytes.
Laminectomy

[edit] References
Thomas, Clayton L. (1985). Taber’s Cyclopedic Medical Dictionary. F.A. Davis Company, Philadelphia, Pennsylvania. ISBN 0-8036-8309-X.
Baron, M. E. (2007). Cervical Spondylosis: Diagnosis and Management. http://www.emedicine.com/neuro/topic564.htm
Towel hot compress can cure 10 kinds of disease . http://www.worldhealthlife.com/towel-hot-compress-cure-disease.html%5Bdead link]

1.^ Rana, Sandeep, “Cervical Spondylosis, Diagnosis and Management: eMedicine Neurology”, “http://emedicine.medscape.com” (March 24, 2010).

[edit] External links

Wikimedia Commons has media related to: Spondylosis

Cervical spondylosis – Click here for exercises as home remedy
Cervical spondylosis at the Mayo Clinic

[hide]
v ·
t ·
e

Dorsopathies / spinal disease (M40–M54, 720–724, 737)

Deforming dorsopathies

Spinal curvature

Kyphosis ·
Lordosis ·
Scoliosis

Other

Scheuermann’s disease ·
Torticollis

Spondylopathy

inflammatory: Spondylitis (Ankylosing spondylitis)
·
Sacroiliitis ·
Discitis ·
Spondylodiscitis ·
Pott disease
noninflammatory: Spondylosis ·
Spondylolysis ·
Spondylolisthesis ·
Spinal stenosis ·
Facet syndrome

Back pain

Neck pain ·
Upper back pain ·
Low back pain (Coccydynia ·
Sciatica)

Radiculopathy

Intervertebral disc disorder

Schmorl’s nodes ·
Degenerative disc disease ·
Spinal disc herniation

M: JNT

anat (h/c, u, t, l)/phys

noco (arth/defr/back/soft)/cong, sysi/epon, injr

proc, drug (M01C, M4)

Categories: Skeletal disorders
Vertebral column disorders
Repetitive transforaminal steroid injections in cervical radiculopathy: a prospective outcome study including 140 patients.

Persson L, Anderberg L.

Source

Department of Clinical Science, Neurosurgery, Lund University Hospital, Lund, Sweden.

Abstract

Study design:  Prospective case series. Objective:  To evaluate the effect of three repetitive transforaminal steroid injections in a large series of selected patients with cervical radiculopathy caused by spondylosis. Methods:  Consecutively, 140 patients with long-lasting medical history, clinical findings, and MRI indicating a cervical nerve root origin based on degenerative disease and a positive selective transforaminal diagnostic nerve root blocks with local anesthetics resulting in at least 50% temporary arm pain reduction were included. Before treatment started, patients underwent a clinical examination by a neurosurgeon. All patients were followed-up and evaluated by one physiotherapist at the neurosurgery outpatient clinic. A designed outcome questionnaire including Neck Disability Index (NDI), Symptoms Frequency Index, and Visual Analog Scale for pain intensity were used. A series of three transforaminal steroid injections, with 3 weeks in between, were performed by a neuroradiologist using image intensifier guidance in an x-ray suite. At 12-14 weeks after the first injection, follow-up was performed. Criteria for positive response to the treatment was >50% radicular arm pain reduction. Except for occasional painkillers, no other treatment was given to the patients. Results:  Positive response to the treatment was achieved in 49% (n = 69) with a significant difference in NDI and pain intensity between responders and nonresponders. Conclusions:  Repetitive transforaminal steroid injections may reduce symptoms (frequency, intensity, and fewer limitations of daily living activities) of radiculopathy in patients with degenerative disease in the cervical spine at a short time follow-up. [Table: see text].

PMID: 23531493 [PubMed – in process]

Linked and pleiotropic QTLs influencing carcass composition traits detected on porcine chromosome 7.

Gilbert H, LE Roy P, Milan D, Bidanel JP.

Source

UR337, INRA, Station de Génétique Quantitative et Appliquée, 78352 Jouy-en-Josas cedex, France. helene.gilbert@dga.jouy.inra.fr

Abstract

A multivariate QTL detection was carried out on fatness and carcass composition traits on porcine chromosome 7 (SSC7). Single-trait QTLs have already been detected in the SLA region, and multivariate approaches have been used to exploit the correlations between the traits to obtain more information on their pattern: almost 500 measurements were recorded for backfat thickness (BFT1, BFT2), backfat weight (BFW) and leaf fat weight (LFW) but only about half that number for intramuscular fat content (IMF), affecting the detection. First, groups of traits were selected using a backward selection procedure: traits were selected based on their contribution to the linear combination of traits discriminating the putative QTL haplotypes. Three groups of traits could be distinguished based on successive discriminant analyses: external fat (BFT1, BFT2), internal fat (LFW, IMF) and BFW. At least four regions were distinguished, preferentially affecting one or the other group, with the SLA region always influencing all the traits. Meishan alleles decreased all trait values except IMF, confirming an opportunity for marker-assisted selection to improve meat quality with maintenance of carcass composition based on Meishan alleles.

PMID: 17669227 [PubMed – indexed for MEDLINE]

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Related citations in PubMed

Metabolic and histochemical characteristics of fat and muscle tissues in homozygous or heterozygous pigs for the body composition QTL located on chromosome 7.[Physiol Genomics. 2007]

Effects of quantitative trait loci on chromosomes 1, 2, 4, and 7 on growth, carcass, and meat quality traits in backcross Meishan x Large White pigs.[J Anim Sci. 2006]

Detection of quantitative trait loci for carcass composition traits in pigs.[Genet Sel Evol. 2002]

Review Genetic aspects concerning drip loss and water-holding capacity of porcine meat.[J Anim Breed Genet. 2007]

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See reviews…See all…

Cited by 2 PubMed Central articles

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Pathology and Pathogenesis of Lumbar Spondylosis and Stenosis
KIRKALDY-WILLIS, W H MD, FRCS (E & C); WEDGE, J H MD, FRCS (C); YONG-HING, K MB, ChB, FRCS (G); REILLY, J MB, ChB

Abstract
Study of autopsy specimens of the lumbar spine makes it possible to construct a spectrum of pathologic change. Progressive degenerative changes in the posterior joints lead to marked destruction and instability. Similar changes in the disc result in herniation, internal disruption, and resorption. Combined changes in posterior joint and disc sometimes produce entrapment of a spinal nerve in the lateral recess, central stenosis at one level, or both of these conditions. Changes at one level often lead, over a period of years, to multilevel spondylosis and/or stenosis. Developmental stenosis is an enhancing factor in the presence of a small herniation or moderate degenerative stenosis. Lesions such as major trauma, spondylolisthesis, those following spinal fusion, Paget’s disease, and fluorosis, on occasion act directly to produce central or lateral stenosis.

(C) Lippincott-Raven Publishers.

Content referenced by
http://en.wikipedia.org/wiki/Spondylosis
http://www.ncbi.nlm.nih.gov/pubmed?term=spondylosis
http://www.ihop-net.org/UniPub/iHOP/index.html?field=all&search=back&organism_id=0
https://www.google.ca/#hl=en&gs_rn=7&gs_ri=psy-ab&tok=oeCsUmcg3SDWUA0i3kJ3mA&cp=34&gs_id=3q&xhr=t&q=top+research+hospitals+spondylosis&es_nrs=true&pf=p&sclient=psy-ab&oq=top+research+hospitals+spondylosis&gs_l=&pbx=1&bav=on.2,or.r_cp.r_qf.&bvm=bv.44342787,d.b2I&fp=95d358fc6f6f5278&biw=1400&bih=753
http://scholar.google.ca/scholar?hl=en&q=spondylosis&btnG=&as_sdt=1%2C5&as_sdtp=