1.
CERVICAL – C1 [ cervical vertebra]
C2
C3
C4
C5
C6
C7
 SPONDYLOSIS – Spondy [ spine]
Losis [ degeneration]

2.
Cervical spondylosis also called as cervical osteoarthritis is a term
that encompasses a wide range of progressive degenerative
changes that affect all the components of the cervical spine
 It is a natural process of aging and presents in the majority of
people
 Neck pain is a widespread condition, and the second most
common complaint after low back pain. This condition is
associated with a significant burden of disease with substantial
disability and economic cost,
 Although ageing is the primary cause, the location and rate of
degeneration as well as degree of symptoms and functional
disturbance varies.

3.
 Evidence of spondylotic change is frequently found in many
asymptomatic adults, with evidence of some disc degeneration in:
 25% of adults under the age of 40,
 50% of adults over the age of 40, and
 85% of adults over the age of 60
 Asymptomatic adults showed significant degenerative changes at 1
or more levels
The most common evidence of degeneration is found at C5-6
followed by C6-7 and C4-5".

4.
1. Ageing is the major factor for developing cervical O.A. [cervical
spondylosis] as the disc between the vertebra become less spongy
and provide less of a cushion
2. Sedentary lifestyle
3. Occupational factors with repetitive movement of hands and fingers
include prolong computer keyboarding and cell phone texting has
played a large role in increased prevelence of neck pain in past 20
years
4. Previous injury to neck
5. Pressure on neck such as gymnast
6. Poor posture might also play role in development of spinal changes
that result in cervical spondylosis

5.
 Dehydrated Disc- It act like cushions between the vertebra of spine
. By the age of 40 , most people spinal disc begin to dry and shrink
which allows more bone to bone contact between the vertebra
 Herniated disc- Bulging or herniated disc which sometimes can
press the spinal cord and nerve root
 Bone spurs- Disc degeneration often result in the spine producing
extra amount of bone sometime called bone spur, pinch the spinal
cord and nerve roots
 Stiff ligaments – ligaments are tissue that connects bone to bone .
Increasing age can make spinal ligament stiffen and calcify making
neck less flexible

6.
Neck stiffness and pain
 Headache that may originate in the neck
 Pain in the shoulder or arms
 Tingling , numbness and weakness in arms ,
hands, legs, or feet
 Lack of coordination and difficulty walking
 Abnormal reflexes
 Muscle spasm
 Pain shooting down into one or both arms

7.
 COMPONENT THAT AFFECTED BY CERVICAL
SPONDYLOSIS ARE-
 1. MUSCLE
 2. DISC
 3. SPINAL CORD
 4. BONE

8.
Three clinical syndromes in which cervical
spondylosis presents:
 1. Axial neck pain, [ Muscle]
 2. Cervical Myelopathy, [spinal cord]
 3. Cervical Radiculopathy [disc]

9.
Axial neck pain
› Commonly complain of stiffness and pain in the cervical
spine that is most severe in the upright position and
relieved with bed rest when removing the load from the
neck
› Neck motion, especially in hyperextension and side-
bending, typically increases the pain
› In upper and lower cervical spine disease, patients may
report radiating pain into the back of the ear or occiput
versus radiating pain into the superior trapezius or
periscapular musculature, respectively

10.
- This occurs when the root of a nerve is pressed on or damaged
as it comes out from the spinal cord in the neck (cervical) region
Radicular symptoms usually follow a myotomal distribution
depending on the nerve root(s) involved and can present as
unilateral or bilateral neck pain, arm pain, scapular pain,
paraesthesia, and arm or hand weakness
Degenerative changes to the joints around the vertebrae and
osteophyte formation produce areas of narrowing which may
impinge the nerve.
Prolapse disc can or cannot affect the nerve and cause
radiculopathy

11.
 , Symptoms of radiculopathy include loss of feeling
(numbness), pins and needles, pain and weakness in
parts of an arm or hand supplied by the nerve.
 These other symptoms may actually be the main
symptoms rather than neck pain. There may be
shooting pains down into the arm. The symptoms are
usually worse in one arm, but may affect both. The
pain may be severe enough to interfere with sleep.
The lower cervical vertebrae are the usual ones
affected, causing these symptoms in the arms.
 However, if the upper vertebrae are involved, the
pain and numbness occur at the back and the side of
the head A doctor's examination may show changes
to the sensation, power and tendon reflexes to areas
of the arm supplied by the affected nerve.

12.
A cluster of complaints and findings due to intrinsic
damage to the spinal cord itself. Numbness,
coordination and gait issues, grip weakness and bowel
and bladder complaints with associated physical
findings may be reported.
› Can initially present with hand weakness and
clumsiness, resulting in the inability to complete tasks
requiring fine motor coordination (e.g., buttoning a shirt,
tying shoelaces, picking up small objects)
› Frequent reports of gait instability and unexplained falls
› Urinary symptoms (i.e., incontinence) are rare and
typically appear late in disease progression

13.
 This occurs when there is pressure on or
damage to the spinal cord itself. Again,
cervical spondylosis is a common cause of
this condition as the degenerative changes to
the vertebra can narrow the canal through
which the spinal cord passes.
 A prolapse of a cervical disc can also cause
myelopathy if the prolapse is into the central
canal of the vertebra. a tumour or infection
can also affects this part of the spinal cord

14.
 The symptoms of a cervical myelopathy may include:
 1. Difficulties with walking. For example, the legs may feel stiff
and clumsy.
 Can initially present with hand weakness and clumsiness,
resulting in the inability to complete tasks requiring fine motor
coordination (e.g., buttoning a shirt, tying shoelaces, picking up
small objects
 2. Changes to the sensation of the hands. For example, it may
be difficult to feel and recognise objects in the usual way and
you may have a tendency to drop things.
 3. Problems with your bladder. For example, you may
experience problems with emptying your bladder, or
incontinence. A doctor's examination may show changes to the
sensation, power and tendon reflexes to the legs and arms

15.
 As osteoarthritis is primarily a clinical diagnosis, patient
history and the physical examination is usually sufficient to
make a confident diagnosis.
 Joint pain and limited range of motion are usual symptoms
in patients with cervical osteoarthritis. The pain tends to
worsen with activity, especially following a period of rest .
 Physical examination follows a normal cervical
examination and includes:-
1. Inspection: posture, oedema, erythema, evidence of
trauma, muscle atrophy, skin abnormalities and joint
deformity.

16.
2. Palpation of facet joints, examining of
anatomic abnormality, temperature .
3. Range of motion of the cervical region and
shoulder region.
5. Neurological evaluation: motor and sensory
evaluation of sensation, reflexes and muscle
strength.
6. Muscle testing: searching for myofascial
trigger points in the sternocleidomastoid,
cervical paraspinal muscles, levator scapulae,
the upper trapezius and suboccipital
musculature.

17.
 An x-ray can reveal any physical damage to the spine, and whether there
are any bone spurs.
 If the patient has severe, radiating arm pain that does not improve, an MRI
test may be useful for looking at the nerve roots, as there could be
a herniated disc.
 An MRI scan can also help pinpoint exactly where the problem is, and
whether surgery is necessary.
 A myelogram is another diagnostic test. A health professional will inject a
colored dye into the spine. This dye shows in imaging scans, such as x-
rays.
 A CT scan can help to assess the bony structure of the cervical spine.
 Electromyography (EMG) and nerve conduction studies (NCS) can help to
assess specific muscles and ne

18.
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