Describe the Pathology, Presentation, Investigation and Management of Spondylosis[]
Basic patient information leaflet: Spondylosis
Pathology[]
Presentation[]
Symptoms listed on NHS Choices
Summary:
1. Compression of adjacent nerve roots causing radiculopathy symptoms
- Paraesthesia
- Brachialgia
2. Compression of spinal cord leading to myelopathy
- Paresis
- Bowel Incontinence
- Urinary Incontinence (rare)
- Fine motor co-ordination difficulties
- Walking difficulties
Investigation[]
Diagnosis methods from NHS Choices
Initial:
- History and Investigation to localise lesion
Imaging:
- X-ray to locate osteophytes
- MRI - definitive investigation to assess cord compression and foraminal stenosis
- CT - may be used if an MRI cannot be performed for medical reasons
Management[]
Conservative
- Lifestyle
- Low Impact exercise
- Physiotherapy
- Aids e.g. medical pillows
- Cervical collar
- Traction
Pharmacotherapy
- Simple Analgesia
- Paracetamol
- NSAIDs
- Weak Opiates
- Neuropathic Pain Pharmacotherapy - used for continuing, uncontrolled pain
- Amitriptyline
- Gabapentin/pregabalin
- Steroid therapy
- Transforaminal nerve root injection
- Muscle relaxants
- Diazepam
Prescribed only as a short course to ease acute muscle spasms.
Surgery
Indications for surgery
- Progression of neurological deficit
- Intractable pain with clear evidence of nerve compression on scanning
Surgical Techniques
- Anterior