Cervical Spondylosis
Cervical Spondylosis is the age-related degeneration ("Wear and Tear") of the cervical spine. It involves the discs, vertebral bodies, and joints, leading to pain and stiffness.
1. Pathophysiology
- Disc Degeneration: Dehydration and loss of height.
- Osteophytes: Bone spurs form at margins (body and uncinate processes).
- Stenosis: Foraminal (pinching nerve root) or Central (pinching cord).
2. Clinical Syndromes
- Axial Neck Pain: Stiffness, morning pain.
- Radiculopathy: Arm pain/numbness.
- Myelopathy: Cord compression symptoms.
- Vertebrobasilar Insufficiency (VBI): Osteophytes compress the vertebral artery, causing dizziness/vertigo on rotation.
3. Physiotherapy Management
- Isometric Exercises: Strengthening neck muscles without movement.
- Posture Correction: Addressing Upper Crossed Syndrome (Chin tucks).
- Modalities: Heat, TENS, Traction (if no myelopathy/instability).
25 Practice MCQs
Q1. The primary cause of Cervical Spondylosis is:
Answer: A). Wear and tear of discs and joints.
Q2. Osteophytes from the Uncinate Process (Luschka) usually compress:
Answer: A). Foraminal stenosis.
Q3. VBI (Vertebrobasilar Insufficiency) symptoms include:
Answer: A). Triggered by neck rotation/extension.
Q4. Cervical Spondylotic Myelopathy (CSM) is caused by:
Answer: A). UMN signs appear.
Q5. A common postural issue associated with spondylosis is:
Answer: A). Increases load on posterior facets.
Q6. Isometric neck exercises involve:
Answer: A). Safe for painful necks to build strength.
Q7. Cervicogenic Headache typically starts in the:
Answer: A). Often from C1-C3 facet joints.
Q8. X-ray feature of spondylosis:
Answer: A). Classic OA signs.
Q9. Which sleeping pillow is recommended?
Answer: A). Maintains neutral alignment.
Q10. Traction Angle for lower cervical spine (C5-C7) should be:
Answer: A). Opens the intervertebral foramina best.
Q11. Lhermitte's sign in spondylosis suggests:
Answer: A). Electric shock on neck flexion.
Q12. Most common levels affected:
Answer: A). Areas of max mobility.
Q13. "Double Crush" phenomenon refers to:
Answer: A). The nerve is compressed at two sites.
Q14. Diffuse Idiopathic Skeletal Hyperostosis (DISH) differs by:
Answer: A). "Forestier's disease".
Q15. Collar use in spondylosis should be:
Answer: A). To avoid muscle atrophy.
Q16. Anterior osteophytes can occasionally cause:
Answer: A). By pressing on the esophagus.
Q17. Manipulation (High velocity thrust) is risky if:
Answer: A). Can cause stroke or cord injury.
Q18. Upper Limb Tension Test (ULTT) helps diagnose:
Answer: A). "Straight leg raise for the arm".
Q19. The "Spurling's Test" is positive if it reproduces:
Answer: A). Neck pain alone is not a positive Spurling's.
Q20. Deep Neck Flexor strengthening targets:
Answer: A). Weak in most neck pain patients.
Q21. Which modality provides deep heat?
Answer: A). Penetrates to the joints.
Q22. Surgery (Decompression) is indicated if:
Answer: A). Or intractable pain > 3 months.
Q23. Gait disturbance in Spondylosis implies:
Answer: A). Spastic gait.
Q24. Soft tissue massage helps by:
Answer: A). Symptomatic relief.
Q25. Tinnitus (Ringing in ears) in spondylosis is due to:
Answer: A). Barré-Liéou syndrome.
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