Spondylosis Dr.Shamekh M. El-Shamy. Spondylosis.

SpondylosisSpondylosis

Dr.Shamekh M. El-ShamyDr.Shamekh M. El-Shamy

SpondylosisSpondylosis

I- Cervical SpondylosisI- Cervical Spondylosis

Definition:Definition:It is a gradual progressive It is a gradual progressive

diffuse degeneration of inter-diffuse degeneration of inter-vertebral discs, affecting the vertebral discs, affecting the most mobile lower cervical most mobile lower cervical vertebvertebraerae

PREDISPOSING FACTORS:PREDISPOSING FACTORS:

1- Old age.1- Old age.

2- Diabetes mellitus.2- Diabetes mellitus.

3- Excessive mobility of the spine as in 3- Excessive mobility of the spine as in labourerslabourers

PathologyPathology

PathologyPathology--

1- Lateral prolapse

2- Posterior prolapse

3- Postero-lateral prolapse

ManifestationsManifestations

b) Posterior root compression:b) Posterior root compression:

--

2)2)Manifestations of cord compressionManifestations of cord compression (Posterior prolapse):(Posterior prolapse):

(Myelopathy)(Myelopathy)

3)Manifestations of root and root 3)Manifestations of root and root compression: compression:

(Myloradiculopathy)(Myloradiculopathy)

Vertebro-basilar insufficiency Vertebro-basilar insufficiency (VBI)(VBI)

It is usually due to compression of upper It is usually due to compression of upper cervical osteophytes on the vertebral cervical osteophytes on the vertebral arteartery.ry.

InvestigationsInvestigations

1)1) Plain X-ray:Plain X-ray:

C.T. scan and M.R.IC.T. scan and M.R.I, ,

MyelographyMyelography

Bone Scan, Bone Scan,

TreatmentTreatment

I- Medical:I- Medical:

II- Physiotherapy:II- Physiotherapy:

III- Surgical:III- Surgical:..

II- Lumbar disc prolapseII- Lumbar disc prolapse

Clinical picture:Clinical picture:

- Age:- Age: Any age. Any age.

- Sex:- Sex: 75 – 80 % in males. 75 – 80 % in males.

- Sites:- Sites: Common sites are LCommon sites are L4-54-5 and L and L55-S-S11, ,

which compresses the spinal nerve below which compresses the spinal nerve below i.e. In Li.e. In L4-54-5 disc prolapse, the prolapsed disc prolapse, the prolapsed

disc compresses Ldisc compresses L55 nerve roots. nerve roots.

ManifestationsManifestations

1- Pain:1- Pain:--

2. Muscle weakness:2. Muscle weakness:

--

--Scoliosis; Scoliosis;

--TendernessTenderness

--

InvestigationsInvestigations1. Plain x-ray:1. Plain x-ray:

--

2. Myelography:2. Myelography:

--

3. Computerized axial tomography (CT):3. Computerized axial tomography (CT):--

4. Electro-physiological studies:4. Electro-physiological studies:

5. CSF:5. CSF:

PrognosisPrognosis

TreatmentTreatment1.1. Drugs:Drugs:

2.2. 2. Surgery (10 % of cases):2. Surgery (10 % of cases):

--

3. Injections:3. Injections:

4. Physiotherapy:4. Physiotherapy:

Thank YouThank You