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Kendriya vidyalaya, afs yelahanka, b’luru-63
CERVICAL SPONDYLOSISBIOLOGY INVESTIGATORY PROJECT
Made by:RAJNI PRIYA
XII B09
SUBJECT TEACHER- Mrs. Nirmala C. Dasar
Kendriya vidyalaya, afs yelahanka, b’luru-63
CERTIFICATEThis is to certify that RAJNI PRIYA, of class
XII-B has successfully completed the investigatory project on Cervical
Spondyolsis under the guidance of Mrs. Nirmala C. Dasar [Biology teacher] during
the year 2015-16.
Signature of external examiner Signature of biology teacher
Signature of Principal
ACKNOWLEDGEMENTAt the very outset I am very much grateful to our beloved and respected teacher Mrs. Nirmala C. Dasar for her kind support and guidance that she has been providing during the preparation of this project.
I express my sincere gratitude to Mr. Y.G. Patil principal of KV AFS Yelahanka, Bengaluru for his kind help and support in preparing this project.
I also express my sincere thanks to my parents who helped me in all aspects in completing this project.
RAJNI PRIYA
Student of class XII-B
INDEX1. Certificate2. Acknowledgement3. Introduction4. Cervical spondylosis5. Causes and Risk factors6. Symptoms7. X-rays showing cervical spondylosis8. Exams and tests9. Treatments10. Case study 11. Bibliography
INTRODUCTIONCervical spondylosis is usually an age-related condition that affects the joints in your neck. It develops as a result of the wear and tear of the cartilage and bones of the cervical spine. While it is largely due to age, it can be caused by other factors as well. Alternative names for it include cervical osteoarthritis and neck arthritis.
According to the studies, the condition is present in more than 90 percent of people over the age of 65, although some have it in such small degrees that they never experience symptoms.For some, it can cause chronic pain, although many people who have it are still able to conduct normal, daily activities.
CERVICAL SPONDYLOSISSpondylosis is a term referring to degenerative osteoarthritis of the joints between the center of the spinal vertebrae and/or neural foramina. If severe, it may cause pressure on
nerve withsubsequent sensory and/or motor disturbances such as pain, parenthesis, or muscle weakness in the limbs.Spondylosis is from Ancient Greek spondylos, "a vertebra", in plural "vertebrae - the backbone".When the space between two adjacent vertebrae narrows, compression of a nerve root emerging
from the spinal cord may result in radiculopathy (sensory and motor disturbances, such as severe pain in the neck, shoulder, arm, back, and/or leg, accompanied by muscle weakness). Less commonly, direct pressure on the spinal cord (typically in the cervical spine) may result in myelopathy, characterized by global weakness, gait dysfunction, loss of balance, and loss of bowel and/or bladder control. The patient may experience a phenomenon of shocks (parenthesis) in hands and legs because of nerve compression and lack of blood flow. If vertebrae of the neck are involved it is labeled cervical spondylosis. Lower back spondylosis is labeled lumbar spondylosis.
Cervical Spondylosis Causes and Risk FactorsAgingCervical spondylosis often develops as a result of changes in your neck joints as you age. Your spinal disks can become dry and begin shrinking around the time you turn 40, reducing the cushioning between the bones in your neck.
Your disks might also develop cracks as you get older. This causes them to bulge or become
herniated. You might also develop bone spurs, or extra bony growths. Herniated disks and bone spurs can put extra pressure on your spinal cord and nerve roots, causing joint pain.
The ligaments in your spine, which are strands of tissue that connect your bones, might also become stiffer as you age. This makes it more difficult or painful for you to move your neck.
Other FactorsCervical spondylosis can develop due to factors other than aging. These include:
Neck injuries. Work-related activities that put extra strain on
your neck from heavy lifting.
Holding your neck in an uncomfortable position for prolonged periods of time, or repeating the same neck movements throughout the day (repetitive stress).
genetic factors (family history of cervical spondylosis)
Smoking.
Being overweight and inactive.
Symptoms Most people with cervical spondylosis don’t have noticeable symptoms. If symptoms do occur, they can range from mild to severe and may develop gradually or occur suddenly.
One common symptom is pain around the shoulder blade. Patients will complain of pain along the arm and in the fingers. The pain might increase on standing sitting, sneezing, coughing, or backward tilting of the neck.
Another common symptom is muscle weakness. Muscle weakness makes it hard to lift the arms or hold objects firmly.
Symptoms often develop slowly over time. But they may start or get worse suddenly. The pain may be mild, or it can be deep and so severe that you are unable to move.You may feel the pain over the shoulder blade. Or it may spread to the upper arm, forearm, or fingers (in rare cases).
The pain may get worse: After standing or sitting At night When you sneeze, cough, or laugh
When you bend the neck backwards or walk more than a few yards
Other common symptoms Neck stiffness that gets worse over time Numbness or abnormal sensations in the
shoulders, arms, or legs (in rare cases) Headaches, especially in the back of the head
Less common symptoms Loss of balance Loss of control over the bladder or bowels (if
there is pressure on the spinal cord)
X-RAYS SHOWING CERVICAL
A physical exam may show that you have trouble moving your head toward your shoulder and rotating your head.Your health care provider may ask you to bend your head forward and to each side while putting slight downward pressure on the top of your head. Increased pain or numbness during this test is usually a sign that there is pressure on a nerve in your spine.Weakness or loss of feeling can be signs of damage to certain nerve roots or to the spinal cord.A spine or neck x-ray may be done to look for arthritis or other changes in your spine.MRI of the neck is done when you have:
Severe neck or arm pain that does not get better with treatment
Weakness or numbness in your arms or handsEMG and nerve conduction velocity test may be done to examine nerve root function.
TREATEMENTSTreatment for cervical spondylosis aims to relieve symptoms of pain and prevent permanent damage to your nerves.Pain relief Over-the-counter painkillersNon-steroidal anti-inflammatory drugs (NSAIDs) are thought to be the most effective painkillers for symptoms of cervical spondylosis. Some commonly used NSAIDs include:
diclofenac ibuprofen naproxen
If one NSAID fails to help with pain, you should try an alternative.However, NSAIDs may not be suitable if you have asthma, high blood pressure, liver disease, heart disease or a history of stomach ulcers. In these circumstances, paracetamol is usually more suitable.
Muscle relaxantsIf you experience spasms, when your neck muscles suddenly tighten uncontrollably, your GP may prescribe a short course of a muscle relaxant such as diazepam.Muscle relaxants are sedatives that can make you feel dizzy and drowsy.Muscle relaxants should not be taken continuously for longer than a week to 10 days at a time.AmitriptylineIf pain persists for more than a month and has not responded to the above painkillers, your GP may prescribe a medicine called amitriptyline.Amitriptyline was originally designed to treat depression, but doctors have found that a small dose is also useful in treating nerve pain. Some side effects when taking amitriptyline, include:
drowsiness dry mouth blurred vision constipation difficulty urinating
Injection of a painkillerIf your radiating arm pain is particularly severe and not settling, there may be an option of a "transforaminal nerve root injection", where steroid
medication is injected into the neck where the nerves exit the spine. This may temporarily decrease inflammation of the nerve root and reduce pain.Side effects include headache, temporary numbness in the area and, in rare cases, spinal cord injury (limb paralysis).
Exercise and lifestyle changesYou could consider:
Doing low-impact aerobic exercises such as swimming or walking – read more about easy exercises.
Using one firm pillow at night to reduce strain on your neck.
Correcting your posture when standing and sitting – read more about how to sit correctly.
The long-term use of a neck brace or collar is not recommended, as it can make your symptoms worse. Do not wear a brace for more than a week, unless your GP specifically advises you to.
SurgerySurgery is usually only recommended in the treatment of cervical spondylosis if:
there is clear evidence that a nerve is being pinched by a slipped disk or bone (cervical radiculopathy), or your spinal cord is being compressed (cervical myelopathy)
There is underlying damage to your nervous system that is likely to worsen if surgery is not performed.
The type of surgery used will depend on the underlying cause of your pain or nerve damage. Surgical techniques that may be used include:
Anterior cervical discectomy – This is used when a slipped disc or osteophyte (lump of extra bone) is pressing on a nerve. The surgeon will make an incision in the front of your neck and remove the problem disc or piece of bone. This procedure results in a fusion across the disc joint.
Cervical laminectomy – The surgeon will make a small incision in the back of your neck and remove pieces of bone that are pressing on your spinal cord. A similar approach is known as a laminoplasty, where bones are spread open to widen the space, but not removed.
Prosthetic intervertebral disc replacement – This relatively new surgical technique involves removing a worn disc in the spine and replacing it with an artificial disc. The results of this technique have been promising, but as it is still new, there is no evidence about how well it works in the long term, or whether there will be any complications.
Most people can leave hospital within three to four days, but it can take up to eight weeks before you can resume normal activities. This may have an impact on your employment, depending on the type of work you do.Many people are recommended to return to work on a part-time basis at first, although you should discuss this with your employer before surgery.Complications of surgeryLike all surgical procedures, surgery on the cervical spine carries some risk of complications, including:
Rare complications associated with general anesthetic – such as heart attack, blood clot in the lung (pulmonary embolism) or a severe allergic reaction (anaphylaxis).
Some mild difficulties with swallowing (dysphasia) – this usually passes within a few months.
Hoarse voice – this is a rare complication, but when it does occur it can be permanent.
Paralysis (inability to move one or more parts of the body) – which could occur if there is bleeding into the spinal canal after surgery, or the blood supply to spinal nerves is damaged.
Infection of the wound after surgery – which is not usually serious and can be treated with antibiotics (deeper spinal infection is more serious but very rare).
CASE STUDY 1 Date: 27-07-2014 Name of patient: Mr. Birendra KumarAge: 48 Sex: MaleName of doctor/hospital:Symptoms/Problems: 10 years of history of chronic neck pain, headache, and episodic vertigo and tinnitus
Diagnosis: a large central herniation of C5/6 discTreatment: ACDF at the C5/6 disc level After surgery, strength in all 4 limbs was significantly recovered, and symptoms of neck pain, headache, vertigo, and tinnitus disappeared.Precautions advised: undergone a follow-up of 12 months(Test report can be attached): X-ray attached with the report
Name of doctor/hospital: Dr. Mamta Sharma (physiotherapist)Symptoms/Problems: A three month history of neck and right shoulder pain Worse when she first wakes up and at the end the day Difficulty in looking over shoulderDiagnosis: cervical degeneration of the discs C3-C6 with mild osteophyte formation Treatment: Hi- TENs (no contraindications) applied for 10 mins. to C5 nerve root Home exercises program (HEP): Cervical retractions, Gentle rotation with over pressure Advised to do heat and ice techniques at home.Precautions advised: to discontinue exercise if produces pins and needles, numbness or dizziness(Test report can be attached): X-ray attached with the report
From the reports above it is clear that though cervical spondylosis is of many types, radiculopathy is the most commonly found. Radiculopathy includes sensory and motor disturbances, such as severe pain in the neck, shoulder, arm, back, and/or leg, accompanied by muscle weakness.
In case 1, the patient is suffering from a longer time and hence, he had to undergo surgery for relief. He had to undergo a follow-up for 12 months after the surgery.
In case 2, since the condition was detected in a very early stage therefore, the patient recovered doing a regular session of exercises as diagnosed by a physiotherapist. The treatment involved following of daily routine exercises strictly. Treatment was considered effective because all goals were met.
Thus, it is clear that cervical spondylosis can be cured in many different ways depending on the extent of harm the patient has suffered. But sure enough, there are numerous treatments to cure cervical spondylosis and make all the sufferings vanish to let the sufferer enjoy a normal life without any problems.