cervical myelopathy/facet syndrome/synovial fold impingement

clinical presentation - myelopathy

• ____ neck pain

• pain that radiates into ____

• s/s may be _____

• tingling/numbness in ____ and one/both ____

• worse with _____

• difficulty manipulating _____ objects

• _____ abnormalities

• changes in _____

• abnormal _____

• myotomes are ____ and _____

• _____reflexive

• positive ____/_____

unilateral, ipsilateral UE, bilateral, UE, LE, extension, small, gait, bowel/blader, dermatomes, weak, spastic, hyper, babinski, hoffman

two causes of cervical myelopathy

spondylosis, PLL/ligamentum flavum degeneration

PLL/ligamenum flavum

• ____

• limits ____

degeneration, flexion

special tests for cervical myleopathy

Lhermittes sign

positive lhermittes sgn

electrical type pain in midline and possibly extremities during cervical flexion

conservative treatment of cervical myelopaty

• yes to ____

• ther ex: _____

immobilization, stabilization

myelopathy may need surgery → operative management

• _____ approach

• no _____

ACDF, bending, lifting, twisting

cervical facet syndrome = _____ of facet joint

inflammation

MOI of cervical facet syndrome

degeneration, trauma

clinical presentation - cervical facet syndrome

• ____ neck pain

• pain that ____ to ____, ____ or _____ region

• limited ____/pain at _____

axial, refers, sub-occipitals, posterior shoulder, midback, ROM, end range

treatment of cervical facet syndrome

• manual: _____ and _____

• ther ex: _____

suboccipital release, cervical manual traction, stabilization

synovial folds: within ___ joint, function to _____ and _____ surfaces

facet, fill space, lubricate

MOI - facet joint synovial folds impingement

• ____ movement that catches fold _____

• typically _____

quick, within itself, whiplash

clinical presentation - facet joint synoval fold impingement

• ____ neck pain

• pain with ____ and _____

• msucle _____

• restricted _____

• loosens up with ____/_____

localized, movement, rest, spasm, ROM, heat, hot shower

treatment of facet joint synovial fold impingement

• modalities: ____, _____

• manual: passive physiological ____, ____, _____

hot pack, TENS, rotation, side flexion, side glide