Spondylosis Dr.Shamekh M. El-Shamy

Spondylosis

I- Cervical Spondylosis  Definition: It is a gradual progressive diffuse degeneration of inter- vertebral discs, affecting the most mobile lower cervical vertebrae

 PREDISPOSING FACTORS: 1- Old age. 2- Diabetes mellitus. 3- Excessive mobility of the spine as in labourers

Pathology

Pathology -

1- Lateral prolapse 2- Posterior prolapse 3- Postero-lateral prolapse

Manifestations

b) Posterior root compression: -

 2)Manifestations of cord compression (Posterior prolapse): (Myelopathy)

 3)Manifestations of root and root compression: (Myloradiculopathy)

Vertebro-basilar insufficiency (VBI)  It is usually due to compression of upper cervical osteophytes on the vertebral arte ry.

Investigations  1)Plain X-ray:

 C.T. scan and M.R.I,  Myelography  Bone Scan,

Treatment I- Medical: II- Physiotherapy:

III- Surgical:.

II- Lumbar disc prolapse

 Clinical picture: - Age: Any age. - Sex: 75 – 80 % in males. - Sites: Common sites are L 4-5 and L 5 -S 1, which compresses the spinal nerve below i.e. In L 4-5 disc prolapse, the prolapsed disc compresses L 5 nerve roots.

Manifestations 1- Pain: -

2. Muscle weakness: -

- Scoliosis; -Tenderness -

Investigations 1. Plain x-ray: - 2. Myelography: -

3. Computerized axial tomography (CT): -

4. Electro-physiological studies: 5. CSF:

Prognosis

Treatment 1.Drugs: 2.2. Surgery (10 % of cases): -

3. Injections:

4. Physiotherapy:

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