- Signs and Symptoms: (see
C-spine Exam)
- pain is earlly symptom, which may be ischemic in origin;
- Myelopathy:
- characterized by weakness (upper > lower extremity);
- ataxic broad based suffling gait, sensory changes;
- rarely urinary retention;
-
myelopathy hand:
- finger escape sign (small finger spontaneously abducts due to
weak intrinsics) indicating cervical
myelopathy;
- upper motor neuron findings such as hyper-reflexia, clonus, or
Babinski's sign may be present;
- funicular pain, characterized by central burning and stinging with or
w/o (Lhermitte's phenomenon - radiatineg lightening like sensations
down back w/ neck flexion) may also be present w/
myelopathy;
- Radiculopathy:
- can be associated with
myelopathy;
- can involve one or multiple roots, and symptoms include neck, shoulder,
and arm pain, paresthesias, and numbness;
- findings may overlap because of intraneural intersegmental
connections of sensory nerve roots;
- lower nerve root at a given level is usually affected;
-
Spurling's Manuever:
- mechanical stress, such as excessive vertebral motion, may exacerbate symptoms;
- gentle neck hyperextension with the head tilted toward the affected side will narrow the
size of the neuroforamen and may exacerbate the symptoms or produce radiculopathy;
-
Shoulder Abduction Relief Test:
- significant relief of arm pain with shoulder abduction;
- this sign is more likely to be present w/ soft disc herniation,
whereas, the test is likely to be negative with radiculopathy
caused by
Spondylosis (osteophyte compression);
