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A condition characterized by formation of multiple osteophytes:  Outgrowth of immature bony processes from the vertebrae, reflecting the presence of degenerative disease and calcification.
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The anterior and lateral aspects of the neck contain a wide variety of vital structures, yet have no bony protection.
Vascular injuries feature vigorous bleeding, absent superficial artery pulsations, an enlarging or pulsatile hematoma, and stroke signs. If there are no severe complaints or recognizable signs of major disability, ask the patient to conduct mild active movements if able to do so without discomfort. Establishment of an adequate airway takes priority over all other concerns with the exception of spurting hemorrhage.
Whenever spinal injury is suspected, a backboard should be used before transporting the patient. After severe neck injury, return to play should not be allowed until after roentgenography indicates proper healing, the neck is stable and painless during passive and active motion, and the neck has been strengthened by progressive therapeutic exercises. After attending to all life-threatening possibilities, a more thorough examination may proceed, but required transportation should never be delayed for this purpose. With the exception of spinal cord damage, injuries of the major blood vessels comprise the highest mortality and morbidity of all neck trauma. Obstruction within the upper airway is the second most common cause of death resulting from head and neck trauma.
Due to its mobility and structure, the cervical spine is the most frequent site of severe spinal nerve injury and subluxations. A well-founded appreciation of normal variations, epiphyseal architecture, development defects, and congenital anomalies is a distinct aid in evaluating injuries of the cervical area. If routine cervical views are normal, then oblique, open-mouth odontoid, flexion, and extension views with most extreme care should be taken to verify symptoms. In a conscious player that has been injured, any neck spasm should be considered the expression of a cervical fracture or dislocation until proved otherwise. With close inspection, one may sometimes note a lucent line tracking along the anterior margin of the cervical vertebrae, representing fatty tissue between the esophagus and anterior longitudinal ligament.
The space available for the spinal cord (diameter of spinal canal) is the narrowest distance between the posterior edge of a vertebral body and the anterior edge of the posterior vertebral arch. Up to 3 mm of displacement of the atlas on the axis infers that the transverse ligament is intact, while ligament rupture is implied if displacement is from 3–5 mm. Bony spurs are common in the cervical spines of male wrestlers, although adjacent intervertebral disc spaces are usually normal.
Carefully evaluate the relationships of the apophyseal joints and spinous processes for possible injury. Intervertebral joint dislocation, unilateral or bilateral, may result from severe flexion trauma.
There are several syndromes to consider under the classification of neurovascular compression syndromes (also termed thoracic outlet or inlet syndromes), each of which may produce the symptom complex or radiating pain over the shoulders and down the arms, atrophic disturbance, paresthesias, and vasomotor disturbances. Strains (1–3 Grades) or indirect muscle injuries are common, frequently involving the erectors. Cervical sprain and disc rupture are associated with severe pain and muscle spasm and are more common in adults because of the reduced elasticity of supporting tissues.
Diagnosis and treatment are similar to that of any muscle strain-sprain, but concern must be given to induced subluxations during the initial overstress.
Wry neck may also be the result of subdiaphragmatic irritation being mediated reflexly into the trapezius and cervical muscles.
Dislocations of upper cervical vertebrae cause a distortion of the neck much like that of torticollis. To relieve muscle spasm, heat is helpful, but cold and vapocoolant sprays have shown to be more effective in acute cases. Isotonic exercises are useful in improving circulation and inducing the stretch reflex, especially in the cervical extensors. Peripheral inhibitory afferent impulses can be generated to partially close the presynaptic gate by acupressure, acu-aids, acupuncture, or transcutaneous nerve stimulation.
During rehabilitation, a cervical pillow is recommended to provide proper postural support while sleeping.
After lateroflexion injuries of the neck, a sharp burning pain may radiate along the course of one or more cervical nerves, the result of nerve contusion due to stretching. Immediate pain may radiate to the back of the head, behind the ear, around the neck, or down towards the clavicle, shoulder, arm or hand.
If the symptoms appear on the opposite side of the forceful bending, undoubtedly a nerve has been "pinched" within the powerful muscles dorsal to the sternocleidomastoid.
Prevention of aggravation requires correction of associated subluxations, strengthening cervical muscles, wearing a plastic roll within a stockinet as a cervical collar or applying a Thomas-type collar, and avoiding dangerous techniques of play.
A similar but more severe nerve injury common in sports is injury to the brachial plexus or its roots which is usually caused by a fall on the shoulder, a blow to the side of the neck, forceful arm traction, or a combination of these mechanisms. Albright describes the "stinger" syndrome as an apparently mild athletic brachial plexus injury that reflects a transient radiculopathy at the time of impact. The condition is initially felt as a painfully severe electrical shock-like dysesthesia that extends from the shoulder to the fingertips. The most common site of injury is at the C5 or C6 root level; and because of this, the most persistent sign will be weakness of the proximal shoulder muscles. The most common lesion associated with the stinger syndrome is cervical sprain with traumatic compression neuritis. The cervical and suprascapular areas of the trapezius frequently refer pain and deep tenderness to the lateral neck (especially the submastoid area), temple area, and angle of the jaw. In discussing this situation, Smith explains that extension of the cervical spine allows the tip of the superior articular process of the posterior joint to glide forward and upward. The vertebral nerve has its origin in the middle cervical sympathetic ganglion, and it offers vasomotor control over the vertebral artery. While only about 6% of spinal cord injuries occurring within sports result in permanent paralysis, even this number is unacceptable inasmuch as many are preventable.
Direct injury to the cord, the nerve roots, or both may be caused by impact forces or shattered bone fragments.
Indirect injury to the cord may be caused by the disturbance of tissues near the spine by violent forces such as falls, crushes, or blows.
Cervical spondylosis is a chronic condition in which there is progressive degeneration of the intervertebral disc(s) leading to secondary changes in the surrounding vertebral structures, including the posterior apophyseal joints. The onset is usually rapid and insidious but may be subjectively and objectively asymptomatic.
The classic picture is one of a middle-aged person with greatly restricted cervical motion with marked muscle spasm, positive cervical compression test, insidious neck and arm pain and paresthesia aggravated by sneezing or coughing, acute radiculopathy from superimposed disc herniation (central herniation produces central neck pain while lateral herniation produces upper extremity pain), and there are usually some muscle weakness and atrophy or fasciculations. Some authorities believe that head weight and postural strains are overemphasized as it has often been established clinically that unless overt trauma can be shown, most neck problems are the result of reflex vasospasm where the reflex originates in the viscera below the diaphragm. It is important to avoid the pitfall of assuming that all the patient's symptoms involving the neck and upper extremities are caused by a cervical spondylosis when it is found radiographically.
Whiting brings out that it is fortunate that most people with cervical spondylosis are asymptomatic because there is no correction per se.
There is a natural tendency for a patient suffering with symptoms of radiculopathy related to cervical spondylosis to improve regardless of the treatment regimen.
In cervical myelopathy, there is a gradual increase in the neurologic signs and symptoms until a leveling off occurs and symptoms remain stationary, unless superimposed trauma ensues.
A pathologic loss of the normal anterior curve of the cervical spine, characterized by a straightening of the spine, results in mechanical alteration of normal physiologic and structural integrity. Symptoms and signs include headaches (occipital, occipital-frontal, supraorbital), vertigo, rigidity due to cervical muscle spasm, limited extension and flexion, tenderness elicited on lateral C4–C6 nerve roots, neuritis involving branches of the brachial plexus due to nerve-root pressure, hyperesthesia of one or more fingers, and loss or lessening of the biceps reflex on the same or contralateral side. Anomalous development of extra ribs in the region of the cervical vertebrae may be a single unilateral rib, be bilateral, or be multiple bilaterally. A cervical rib arising from C7 and ending free or attached to the T1 rib appears in the neck as an angular fullness which may pulsate owing to the presence of the subclavian artery above it. The etiologic theories of the cervicobrachial syndrome are compression of the nerve trunks, trauma to nerve trunks, injuries to the sympathetic and vasomotor nerves, trauma to the scalenus anterior muscle, embryologic defects, postural or functional defects, narrowing of the upper thoracic cap as a result of adjacent infections or anatomic defects, acute infection producing myositis, intermittent trauma to the subclavian artery, or a cervical rib. Fractures of the cervical spine are usually the result of blows, falls, or vehicular accidents. Atlanto-occipital dislocations, often bilateral, are usually quickly incompatible with life.
Odontoid fractures are often produced by severe forces directed to the head, and the direction of force usually determines the direction of displacement. Compression or flexion damage is sometimes seen, but extension injuries (eg, whiplash) are more common. Cailliet points out that it is difficult to visualize a sprain causing rupture of the ligaments of a joint without causing some derangement of the opposing joint surfaces, which by definition is a degree of luxation or subluxation. Vertebral subluxations are difficult to classify under normal categories of injury becasue they can involve bone, joint, muscle, ligament, disc, nerve, cord, spinal fluid, and vascular tissues.
Loss of mobility of any one or more segments of the spine correspondingly influences its circulation.
Once a vertebra loses its ideal relationship with contiguous structures (subluxation) and becomes relatively fixed at some point (fixation) within its normal scope of movement, it is no longer competent to fully participate in ideal coordinated spinal movement. The dura mater of the spinal cord is firmly fixed to the margin of the foramen magnum and to the 2nd and 3rd cervical vertebrae. The superficial sensory cutaneous set of the cervical plexus (C1–4) is frequently involved in subluxations of the upper four segments, particularly when there are predisposing spondylotic degenerative changes.
De Rusha points out that dysphagia and dysarthria may at times be due to upper cervical involvement rather than a central nervous system situation.
Irritative lesions involving the cervical region and its articulations may in turn irritate the sympathetic nerve plexuses ascending into the head via the vertebral and carotid arteries.
When direct nerve root involvement occurs on the posterior root of a specific neuromere, it manifests as an increase or decrease in awareness over the dermatome. In other instances, this nerve root involvement may cause hypertonicity and the sensation of deep pain in the musculature supplied by the neuromere. Phillips states that if a subluxation produces a stretching of the paravertebral musculature, there will be a continuous barrage of afferent impulses in the Ia fibers. In cervical spondylosis, the edges of the vertebrae often develop small, rough protrusions of the bone ( osteophytes) which are in response to thinning of discs . Mostly asymptomatic, these osteophytes may cause compression on nearby muscles, ligaments, or nerves to cause pain in neck and surrounding area.
Cervical spondylotic myelopathy refers to changes in cord due to cervical spondylosis that cause weakness of the hands and other parts of the body.
Cervical spondylotic myelopathy is discussed separately as its presentation is quite different. Conditions that cause increased mobility or instability to a segment of cervical spine  like congenitally fused spine, cerebral palsy, Down syndrome etc may be risk factors for cervical spondylosis. Osteophytes may cause narrowing of the intervertebral foramina [A canal through which the nerve root comes out of spine] and irritation of nerve root. The pain  is often accompanied by stiffness, with radiation into the shoulders or skull. Paresthesias may accompany pain  in cervical region, the upper limb, shoulder or interscapular region. Routine anteroposterior x-rays of the cervical spine demonstrate loss of cervical lordosis, disc space narrowing, osteophytes, facet joint osteoarthritis etc.
Pain of cervical spondylosis and Cervical radiculopathy usually resolves without intervention.
Non steroidal anti-inflammatory drugs are mainstay of drug treatment for reducing inflammation and pain.
Muscle relaxants such as thiocolchicoside, tizanidine, carisoprodol and cyclobenzaprine may help patients with neck spasms. Use of  opioid drugs is restricted to patients who are not relieved with above drugs or do not tolerate non steroidal anti-inflammatory drugs or have moderate-to-severe pain due to significant structural spondylosis. Lifestyle modifications includes posture improvements, ergonomic changes in workplace, relaxation techniques to avoid starin on cervical spine. The surgeries done  are foraminotomy, anterior cervical discectomy with fusion, cervical disc replacement etc. About Dr Arun Pal SinghArun Pal Singh is an orthopedic and trauma surgeon, founder and chief editor of this website. This website is an effort to educate and support people and medical personnel on orthopedic issues and musculoskeletal health.
I have problem with Cervical Spine sciene last 2 year, for that i am faceing problem of solder & nack pain, give me the proper solution.
When you ask for a medical advice, you should provide maximum possible information to the person from whom you seek the advice.
I have been experiencing neck, shoulder and arm pain since a car accident in July of last year. Do you have any pain on movements of shoulder especially when you lift it upwards as in saying Hail or goodbyeing? I know this is OA, but 1) I am only 41 yoa 2) I have never had any back or neck issues, ever 3) I do not have any Calcium deficiencies, and actually was told I had high levels of calcium from having calcium in our water where I grew up 4) I am not peri or menopausal and have my hormone levels checked every year and actually just did about 1 month ago! Discuss the things with you treating doctor and if you need another opinion, you may see a second doctor. Can cervical spondylosis give symptoms such as 'heat' in the lower back, buttock area and under the feet? Per se spondylosis does not cause disability but if your work involves manual labour, you might find that difficult. When massage is included in chiropractic treatment, studies have shown the recovery times are faster.
Specializing in the assessment, diagnosis, and treatment of spine and extremity musculoskeletal disorders. Your neck, also called the cervical spine, begins at the base of the skull and contains seven small vertebrae. While the cervical spine can move your head in nearly every direction, this flexibility makes the neck very susceptible to pain and injury.  The neck’s susceptibility to injury is due in part to biomechanics.
Severe Neck Pain: Often begins suddenly such as after an injury or trauma like wrecking a car and being subjected to whiplash.
Chronic Pain: Is often related to a previous injury that caused joint misalignment leading to structural or arthritic degenerative changes in the connective tissue of the spine. Injury and Accidents: A sudden forced movement of the head or neck in any direction and the resulting “rebound” in the opposite direction is known as whiplash.
Growing Older: Degenerative disorders such as osteoarthritis, spinal stenosis, and degenerative disc disease directly affect the spine. Spinal Stenosis: Causes the small nerve passageways in the vertebrae to narrow, compressing and trapping nerve roots. Degenerative Disc Disease: Can cause reduction in the elasticity and height of intervertebral discs.
Daily Life: Poor posture, obesity, and weak abdominal muscles often disrupt spinal balance, causing the neck to bend forward to compensate.


Stress and emotional tension: Can cause muscles to tighten and contract, resulting in pain and stiffness.
During your visit, the doctor of chiropractic will perform exams to locate the source of your pain and will ask you questions about your current symptoms and remedies you may have already tried. During the neurological exam, your doctor will test your reflexes, muscle strength, other nerve changes, and pain spread.  In some instances, your chiropractor might order tests to help diagnose your condition. A computerized axial tomography scan (a CT or CAT scan) or a magnetic resonance imaging test (an MRI) can show bulging discs and herniations. Neck Adjustments: A neck adjustment (also known as a cervical manipulation) is a precise procedure applied to the joints of the neck, usually by hand. The chiropractor will develop a program of care that may combine more than one type of treatment, depending on your personal needs.
One of the most recent reviews of scientific literature found evidence that patients with chronic neck pain enrolled in clinical trials reported significant improvement following chiropractic spinal manipulation.
ChiropracticWe look at the whole picture, and like other health-care providers, we follow a standard routine to gain information about the patient. Cervical Spine Surgery Hospitals in Chennai, India are offering treatment at a reasonable price. Cervical spine surgery may help if other medical options for cervical spine disease fail or if symptoms worsen.
Cervical spine disease is usually caused by herniated intervertebral discs, abnormal growth of bony processes on the vertebral bodies (osteophytes), which compress spinal nerves, trauma, and narrowing (stenosis) of the spinal column around the spinal cord.
Cervical spine surgery is done for treating the patient with (general anesthesia) to avoid surgical pain.
Cervical Spine Surgery Hospitals in Chennai, India are certified and are equipped to perform the most complex spine surgeries.
I took these pictures during a recent visit Alli and I had to the Smithsonian Institute in Washington DC. As you can see, all these spines have all been structurally modified and there’s not a corrective exercise program in the world that could change that. Push yourself to the limits with strength and power lifts and progressions, power training drills, and cardio conditioning workouts. To bring you this program, I’ve teamed up with New York Giants punter Steve Weatherford, who is also known as one the NFL’s fittest men.
Schafer's books are now available on CDs, with all proceeds being donated to chiropractic research. Partial protection is provided by the cervical muscles, the mandible, and the shoulder girdle.
Due to relative head weight to neck strength and other anatomic differences, neck injury is more critical in the very young.
The patient should never be asked to sit or stand until major disability has been ruled out. If slight straight axial compression on top of the head produces unilateral or bilateral radiating root pain, deep injury must be suspected and precautions taken immediately. After injury to the anterior neck, tenderness and crepitus in the thyroid area associated with hoarseness or signs of respiratory distress signal the need for probable emergency intubation. Gentle constant hand traction should be applied to the chin and occiput while transfer is being made to a board. Dressings applied to the neck must be tied over the head or downward under the opposite armpit, but never around the neck. The most serious consequences are those of airway obstruction from blood, air embolism, spurting hemorrhage, cerebral infarct, and neurologic deficits consequent to cerebral hypoxia. However, because it has extremely delicate walls, it can be easily injured by internal (eg, foreign body ingestion, exploration) or external penetrating wounds. In sports, a wide variety of cervical contusions, 1–3 Grade strains and sprains, subluxations, disc syndromes, dislocations, and fractures will be seen.
After the age of 8 years, the neck, with few exceptions, attains an adult form where growth plates present few diagnostic problems. Flexion and extension views will indicate the extent of ligament rupture and bony displacement, but the danger of causing further damage is great.
Dislocation or severe subluxation of C1 at the occipital junction may be seen, especially on the lateral view, and be associated with widening of the prespinal soft-tissue space following hemorrhage. This strip may be displaced anteriorly in spinal trauma and present the only evidence of injury. When displacement exceeds 5 mm, it may be assumed that the ligament has ruptured and the accessory ligaments are stretched and partially deficient. Keep in mind that severe neurologic damage may be present without roentgenographic evidence (eg, brachial plexus injury), thus indicating a possible need for myelography after acute injury to elicit evidence of an avulsed nerve-root sleeve, intramedullary hemorrhage, bone fragments, or edema. Check for possible vertebral compression fractures by evaluating the anterior aspects of the vertebral bodies for collapse and comparing their margins. If pulse abnormalities or bruits are found, the test is positive for carotid, vertebral, or basilar artery obstruction (stenosis or compression), and the second maneuver should not be conducted. Flexion and extension cervical sprains are also common in sports (1–3 Grades), and usually involve the anterior or posterior longitudinal ligaments, but the capsular ligaments may be involved. A fracture-dislocation of a cervical vertebra will produce neck rigidity and a fast pulse, but fever is absent. These exercises should be done supine to reduce exteroceptive influences on the central nervous system. Most authorities feel deep sustained manual pressure on trigger points is the best method, but a few others prefer brutal short-duration pressure (1–2 sec).
Grade 2 injuries should invariably be provided with an immobilization collar to provide support assistance and protection during the early stages of healing. There are frequent arm paresthesias, severe arm weakness if not lack of active motion, often decreased biceps and triceps reflexes, forearm numbness, and cervical movement restriction. If this be the case, symptoms usually subside in a few minutes with only slight residual tenderness and paresthesia which disappear within a few hours. The injury is essentially caused by acute shoulder depression which stretches the brachial plexus, especially in the supraclavicular area. This feeling passes within a few moments and is replaced by sensations of numbness and upper extremity weakness that may last from a few seconds to several minutes.
Infrequently, an acute cervical disc rupture or a spontaneously reduced hyperextension dislocation may be associated. The sternal division of the sternocleidomastoideus refers pain chiefly to the eyebrow, cheek, tongue, chin, pharynx, throat, and sternum. Extremes of rotation and flexion occur at the upper cervical region, but the four normal curves in the vertebral artery help to compensate for neck movements. The Barre-Lieou syndrome is thought to be the result of vertebral nerve irritation that causes a circulatory impairment in the area of the cranial nuclei, especially those of the trigeminal and auditory nerves. When pain is elicited, it is a sign suggesting irritation of the spinal dura matter either by a protruded cervical disc, tumor, fracture, or multiple sclerosis.
Most injuries are caused by extreme flexion where subluxation, fracture and dislocation may be associated. This type of injury, which is normally closed with respect to the spinal column and cord, is of a lesser degree than direct injury. It is the result of direct trauma (ie, disc injury), occupational stress, aging degeneration, or found in association with and adjacent to congenitally non-segmented vertebrae. The Davis series may suffice, but special views, tomography, myelography, or discography may be necessary for firm diagnosis. Cervical spondylosis is common, and symptoms may thus be associated with unrelated neurologic disease which may coexist with the spondylosis, making the diagnosis more difficult.
Treatment is aimed at reducing symptoms of neurologic vasoneurologic involvement or treating the soft-tissue injury superimposed on the pre-existing spondylosis.
Unfortunately, the degenerative changes of the intervertebral disc, vertebral bodies, and associated diarthroidial joints are permanent and, in most cases, progressive.
Although conservative care does produce remission of subjective symptoms, especially in early diagnosed cases, objective signs are very rarely changed and sensory symptoms return and progress to a plateau. The condition occurs more frequently after the age of 40, and the sexes appear equally affected. The condition is usually seen at C7, and the cause is a variation in the position of the limb buds.
The 4th and 5th decades mark the highest incidence, probably because of regressive muscular changes. Most cervical fractures are characterized by neck pain that tends to radiate into the trapezius and upper extremities. Any severe subluxation in the upper cervical area can lead to quadriplegia or death, often with little warning and few symptoms to differentiate it initially from a mild strain. Of all atlantoid fractures, most literature states that those of the posterior arch are the most common yet easily overlooked as the displacement is usually mild.
This is the most common type of axial fracture, and the cruciate ligaments on the posterior aspect of the odontoid may remain intact. In os odontoideum, the process is about 50% smaller than normal, round, and separated from the hypoplastic odontoid by a wide gap. They are usually the result of a football pile-up, trampoline, gymnastic, vehicular, or diving accident. Spinous process fractures usually occur at the C6 or C7 level after acute flexion or a blow to the flexed neck producing ligamentous avulsion.
If a "whiplash" injury is considered a severe sprain, a subluxation injury must be assumed. Thus, sternoclavicular and acromioclavicular neuralgias may originate in the spinal levels of the supraclavicular nerve.
The C1 joins the hypoglossal cranial nerve which supplies the intrinsic muscles of the tongue.
Some cases of visual and aural symptoms are related to upper cervical distortion where the arch of the atlas snugly hugs the occiput, thus possibly irritating the sympathetic plexus of nerves on the vertebral arteries as well as partial compression of the vessels. These disturbances may be through one of two primary mechanisms: direct nerve or nerve root disorders, or of a reflex nature. In addition, direct pressure over the nerve root or distribution may be particularly painful.
These reflexes must also be compared bilaterally to judge whether hyporeflexia is unilateral. Involvement of a nerve leading to pain and other symptoms in upper limb is called cervical radiculopathy. However repeated occupational trauma like carrying loads, professional dancing, gymnastics etc. Degradation of  intervertebral discal proteoglycans also causes irritation of nerve root. Space  may be further worsened by hypertrophy of the ligamentum flavum, thickening of bone, degenerative kyphosis and subluxation.
The pain usually comes and goes but may persist in some persons with occasional exacerbation.
MRI may be indicated in cases where radiculopathy is not amenable to treatment or in cases of spondylotic myelopathy to assess cord damage. The treatment includes neck immobilization, drug treatments, lifestyle modifications and physical modalities like traction, manipulation and  exercises. Patients with chronic symptoms should receive  tricyclic antidepressants like amitriptylene. When i finally got an x-ray done, it shows that my cervical spine is very straight instead of curved. She got operated ine spine as doctors says it was lumbar spondlysis.But no reduction in pain. Incredibly, the cervical spine supports the full weight of your head, which is on average about 12 pounds. Activities and events that affect cervical biomechanics include extended sitting, repetitive movement, accidents, falls and blows to the body or head, normal aging, and everyday wear and tear. Muscles, ligament, discs and nerves may have tearing of connective tissue, swelling and inflammation. A chiropractic examination will identify the cause of the neck pain and determine the appropriate course of treatment. The sudden “whipping” motion injures the surrounding and supporting tissues of the neck and head.
Stenosis may cause neck, shoulder, and arm pain, as well as numbness, when these nerves are unable to function normally. Over time, a disc may bulge or herniate, causing tingling, numbness, and pain that runs into the arm. Postural stress can contribute to chronic neck pain with symptoms extending into the upper back and the arms. In the physical exam, your doctor will observe your posture, range of motion, and physical condition, noting movement that causes pain. If nerve damage is suspected, your doctor may order a special test called electromyography (an EMG) to measure how quickly your nerves respond.
A neck adjustment works to improve the mobility of the spine and to restore range of motion; it can also increase movement of the adjoining muscles. In addition to manipulation, the treatment plan may include mobilization, massage or rehabilitative exercises, or something else.
If you are thinking about getting spinal treatment in India then you have made the right decision because the medical facilities available at various Cervical Spine Surgery Hospitals in Chennai, India are at par with the best hospitals of this world. A vast majority of people -- approximately 60% -- with pain due to cervical spine disease will get better on their own over time with simple, conservative treatments but the rest of persons often face serious complications due to failure of general medications and physical therapy. For treating cervical spine, an incision may be made either in the back of the neck (posterior cervical) or in the front side of the neck (anterior cervical), depending on the location of the problem.
They specialize in offering surgery to high risk patients with the preamble of innovative techniques of plainly insidious and robotic surgery package. Injuries of the upper airway or ailmentary canal feature ventilation abnormalities, stridor, bubbling wound, subcutaneous emphysema, hoarseness and dysphagia, bloody sputum, nosebleed, bloody vomitus, or unexplained wound tenderness. Such an injury should be suspected if there is a diagonal erythematous contusion on the side of the neck.
The airway in the neck region may be obstructed by blood, mucus, edema, and broken parts of the trachea and larynx. The head should be laterally fixed with sandbags or rolled cloth, and the rest of the body with straps. Seek signs of bleeding, discoloration, swelling, lack of superficial pulses, or auscultated bruits. In this regard, the cricoid and thyroid cartilages are quite vulnerable to direct trauma of the neck. Simple tears of the oropharynx or nasopharynx respond well to saline irrigation, restricting solid food, and taking precautions against infection. Much cervical spine injury can be attributed to the relatively small vertebral bodies, the wide range of movement in many planes, and the more laterally placed intervertebral articulations which requires nerve roots to leave the spinal canal in an anterolateral direction. On the lateral view, the anterior and posterior soft tissues, the atlanto-occipital articulation area, vertebral bodies, disc spaces, facet joints, and spinous processes should all be carefully evaluated. A complete radiographic study of the cervical spine can usually be accomplished with the views of the Davis or the modified-Davis series.
The soft-tissue shadows anterior to the upper cervical vertebrae are normally narrowest in the upper cervical area and seldom wider than a C6 vertebral body's A–P dimensions in the lower cervical area.
The width of the odontoid is approximately equal to the width of the spinal cord at the C1 level, and thus is a guide to the space available for the cord.
Atlantoaxial instability is commonly caused by odontoid fracture, rheumatoid arthritis, and odontoid anomalies. Posterior vertebral margins are compared for signs of subluxation or dislocation; ie, a continuous line passing through each posterior vertebral margin should be smooth and unbroken.
On an oblique view, the facets will be shingle-like and the end-on images of the lamina will appear as a chain of ovals.


In some cases, poor posture, anomalies, muscle contractures, or other factors may be responsible. Painful bruising and tender swelling will be found without difficulty, especially if the neck is flexed. Cervical stiffness, muscle spasm, spinous process tenderness, and restricted motion are common. Deep pressure is contraindicated in any patient receiving anti-inflammatory drugs (eg, cortisone) as subcutaneous hemorrhage may result. This is often referred to as a "hot shot" or "pinched nerve" by players and sports writers.
On the other hand, if symptoms appear on the same side as the direction of the forceful bending, deep skeletal injury such as fracture, dislocation, severe rotary subluxation, or nerve compression may be involved. The injury usually occurs when the neck is forcibly hyperextended and laterally flexed, and symptoms can usually be precipitated in this position during examination.
Repetitive injuries of this nature, however, tend to have an accumulative effect that may lead to axonotmesis and chronic muscle weakness, which may take up to 6 months for full recovery. These later disorders are far more serious and usually require hospitalization until the severity of the injury can be properly assessed.
Hemorrhage may occur at the site with the same reaction as brain injury (liquefaction, softening, disintegration). If the space in which the spinal fluid flows between the spinal cord and the surrounding vertebral column is either compressed or enlarged, severe headache occurs. Incidence is high in the second half of life with increasing severity in advancing years; 60% at 45 years, 85% at 65 years. Pre-existing spinal stenosis, thickened ligamentum flavum, protruding disc, and spur formation not uncommonly complicate the picture of cervical spondylosis. Treatment is therefore aimed at reducing symptoms and future attacks by proper case management and prophylaxis. Thus, suggests Whiting, surgical intervention is probably the treatment of choice in severe myelopathy once the symptoms return following a trial of conservative care or if there is evidence of paralysis.
The cause is usually the result of trauma-producing whiplash injury, herniated disc, subluxation, dislocation, fracture, or ligamentous injury. One or more symptoms are frequently aggravated with an abnormal position of the head such as during reading, sleeping, or driving.
The bone can be felt behind the artery by careful palpation in the supraclavicular fossa and demonstrated by roentgenography. Thus, it is always better to be extra cautious (and be accused of being overly concerned in mild injuries) to insure against a possible disaster. Occasionally the odontoid will not be displaced but slightly angulated as a result of a toggle effect on flexion-extension films. A small bone chip separated from the anterior-inferior rim of the axis at the point of rupture of the anterior longitudinal ligament may be a clue. The remnant hypoplastic odontoid appears as a hill, forming upward from the slope of the superior articular facets.
There is immediate "hot" pain in the area of the spinous process which is increased by flexion. The artery and vein supplying a spinal nerve are situated in the foramen between the nerve and the fibrous tissue in the anterior portion of the foramen. In addition to the attending circulatory, neuromechanical, and static changes in the involved area, there is disturbed reflex activity which may be exhibited as changes in superficial and deep reflexes, hyperkinesia, pupiliary changes, excessive lacrimation, tremors and spasms. Since both the C1 nerve and the vertebral artery pass through this membrane and both are beneath the superior articulation of the atlas and beneath the over-hanging occiput, atlanto-occipital distortion may cause traction of the dura mater producing irritation of the artery and nerve unilaterally and compressional occlusion contralaterally.
To appreciate this, note that the visual cortical area of the occipital lobe requires an ideal blood supply dependent on the sympathetics ascending the great vessels of the neck, and this holds true for the inner ear as well.
This area includes the cervical portion of the sympathetic gangliated chain and the 9th–12th cranial nerves as they exit from the base of the skull and pass into their compartments within the deep cervical fascia. Acute neck pain gradually get better and resolves as the injury heals, usually within several months. Muscles react by tightening and contracting, creating muscle fatigue, which can result in pain and stiffness. The doctor will feel your spine, note its curvature and alignment, and feel for muscle spasm; as well as a check of your shoulder area. Patients typically notice an improved ability to turn and tilt the head, and a reduction of pain, soreness, and stiffness. In such cases doctors and spine treatment experts perform the procedure of cervical spine surgery. Cervical Spine Surgery Hospitals in Chennai, India are at the forefront of providing superior cervical spine surgery - both invasive and non-invasive. Scoliosis is hereditary in that people with scoliosis are more likely to have children with scoliosis; however, there is no correlation between the severity of the curve from one generation to the next. The peak incidence occurs in the third decade, with 90% of the accidents occurring in males.
Without moving the patient, check vital signs and palpate for swelling, deep tenderness, deformity, and throat cartilage stability. Injuries to the cervical nerves are suggested by deviation of the tongue, drooping mouth corner, sensory deficits, and Horner's syndrome.
Clearing the mouth (not the pharynx) with the fingers, together with postural drainage in the semiprone position, may be successful, but care must be taken not to force debris further down the airway with probbing fingers. It is easy to miss lower cervical fractures inasmuch as they are often obscured on lateral views by the subject's shoulders if proper precautions are not taken. Such a series is recommended when there is a history of trauma to the cervical spine and adjacent tissues or a history of chronic complaint and symptoms of possible pathology. The retropharyngeal space should not exceed 7 mm, and the retrotracheal space should not exceed 22 mm. Whether or not a subluxation appears, a fracture may be located in the neural arch or facet joint.
In addition, subluxation syndromes may initiate these and other disturbances of the shoulder girdle and must be further evaluated. Phillips points out the necessity of normally lax ligaments at the atlanto-axial joints to allow for normal articular glidding, thus making tonic muscle action the only means by which head stability is obtained. When pain is present, it is often poorly localized and referred to the occiput, shoulder, between the scapulae, arm or forearm (lower cervical lesion), and may be accompanied by paresthesias. When the longissimus capitis or the trapezius are strained, they stand out like stiff bands. For example, place the patient prone on an adjusting table in which the head piece has been slightly lowered. The effects of cervical traction are often dramatic but sometimes short lived if a herniated disc is involved. Vapocoolant sprays to isolated sites often produce rapid spasm reduction of affected areas. In later years, it is commonly associated with bony spurs from covertebral joints or grossly hyperplastic posterior vertebral articulations from arthrosis. As a result of pressure against the artery, there may be temporary lessening in the volume of blood flow. Congenital fusions and stenosis may predispose a child to spinal cord trauma during a sporting activity. The cord may cease to function below the site at which the force was applied even if the cord itself received no direct injury. There is almost no correlation between the degree of perceived pain in the neck and the degree of arthritic changes noted in x-ray films.
Torticolis, arthritis, malignancy, tuberculosis, osteomyelitis, and other pathologies may be involved.
A small rudimentary rib may give rise to more symptoms than a well-developed rib because of a fibrous band attached between the cervical rib and sternum or 1st thoracic rib. Localized tenderness, upper extremity motor and sensory disturbances, and easy fatigue of involved musculature is common. The typical mechanism is hyperextension with compression of the posterior atlantal arches between the occiput and axis pedicles.
About 36% of these fractures occur through the cancellous bone of the body of the axis, are stable, and heal without difficulty.
The fracture line in nonunion is narrow and at or below the level of the superior articular facets, and the process is normal in size and shape. Seek signs of vertebral tenderness, limitation in movement, muscle spasm, and neurologic deficits.
It is unlikely that circulation to the nerve would be disrupted without first irritating or compressing the nerve because the arteries and veins are much smaller, blood pressure within the lumen makes them not easily compressed, and nerve tissue is much more responsive to encroachment irritation.
This helps us understand those cases of suboccipital neuralgia where a patient upon turning his head to one side increases headache and vertigo which are relieved when the head is turned to the opposite side.
A loop of nerves, the ansi hypoglossi which supplies muscles necessary for deglutition and speaking, is derived from C1–C3. To test this syndrome, De Rusha suggests having the supine patient read some printed matter while the examiner places gentle traction on the skull, separating occipital and atlantal articulations.
The muscle stretching also initiates afferent impulses in the Group II afferents from flower spray endings which may reinforce the spastic muscle condition." He goes on to say that trauma to facet joints, disturbed articular relationships, spasms of closely related muscles, and overlying trigger points --all the results of a subluxation-set up a barrage of flexor-reflex afferent impulses via the Group II–IV fibers that converge upon the internuncial pool in lamina seven of the spinal cord. Severe whiplash can also be associated with injury to the intervertebral joints, discs, ligaments, muscles, and nerve roots. Most of the Cervical Spine Surgeons in India are certified and have an experience of working abroad. A combination of high quality and low cost medical treatment is attracting a large number of patients from all over the world.
When logical, another person should apply gentle bilateral traction on the cervical area via the skull during palpation. If not successful, an emergency surgical airway must be performed promptly by the most experienced person available. Signs of free air, edema, or hemorrhage may be seen in the prespinal and anterior area of the neck. Always x-ray before performing a cervical compression test, especially when the patient has been involved in trauma, to rule out possible arteriosclerosis, disc compression, fracture, avulsion, gross subluxation, dislocation, or bone disease. Anterior injuries are more common to the head and chest as they project further anteriorly, but a blunt blow from the front to the head or chest may result in an indirect extension or flexion injury of the cervical spine. Neck rigidity may also be the result of a sterile meningitis from blood in the cerebrospinal fluid. The syndrome is also seen in wrestling, squash (sidewall collision), and collisions in basketball.
With age and the gradual increase in degenerative changes, attacks are more closely spaced, and recovery from each attack is prolonged. Differential diagnosis must exclude infectious neuritis, arthritis of the shoulder joint, cervical arthritis, subachromial bursitis, deformities, and cardiac disease.
Referred pain may radiate to the scalp, and upper extremity pain and paresthesiae may be present. Tenderness may be acute over the posterior atlas, aggravated by mild rotation and extension.
Retropharygeal swelling is usually absent, and oblique views are often necessary for demonstration.
As in upper-cervical damage, careful emergency management is necessary to avoid paralysis and death. The weight of the head along with activity stress may contribute to chronic degenerative spondylosis often superimposed upon asymptomatic anomalies. In addition, there is a synapse between the upper cervical nerves and the trigeminal which also supplies the dura mater. A positive sign is when the patient, often to his surprise, experienecs momentarily enhanced visual acuity or a reduced tinnitus. My neck was pain free for the most part before the car accident, but it was weak from what I've learned.
Various Cervical Spine Surgery Hospitals in Chennai, India are treating international patients on a daily basis with good success rates. High-speed sports such as seen with vehicle accidents, football backs and ends, gymnastics, diving, skiing, surfing, and horseback riding have the highest injury rate. Venous thrombosis, masses, and exudates may produce visible and palpable edema in the neck. A minor airway obstruction may soon become suddenly life threatening or be delayed for several hours after injury. After trauma, an increase in soft-tissue width is presumptive evidence of hemorrhage or edema from fracture.
Many cervical strains heal spontaneously but may leave a degree of fibrous thickening or trigger points within the injured muscle tissue. With head weight alone serving as the stretching force, the spasm should relax within 2–3 min. Symptoms (the Barre-Lieou syndrome) include headache, vertigo, nausea, vomiting, nystagmus, and suboccipital tenderness, which may be exaggerated by cervical extension.
Injuries to the spinal column in which the cerebrospinal fluid is rapidly depleted may be fatal.
Any superimposed trauma on silent cervical spondylosis can result in permanent partial disability of the cervical spine with symptoms out of proportion to the severity of the injury.
Ring fractures are frequently produced by blows on top of the head where forces are dispersed laterally, fracturing the arches of the atlas and spreading them sidewards. Clinically, a vicious cycle is seen where subluxation contributes to degenerative processes and these processes contribute to subluxation.
This explains why irritation of C1 results in a neuralgia not only confined to a small area at the base of the skull but is also referred to the forehead or eye via the supraorbital branch of the trigeminal.
Palpate the neck with the patient supine so that the muscles are relaxed and the head may be passively controlled.
Residual joint restriction following acute care is more common in traditional medical care than under mobilizing chiropractic supervision. Thumb pressure, placed on a trigger area, is then directed towards the muscle's attachment and held for a few moments until relaxation is complete.
Sometimes symptoms are aggravated by dorsal extension and relieved by forward flexion with cervical traction. Compression of vascular structures results in moderate pain, edema, swelling, and obstruction of circulation resulting in clotting within the vessels with possible consequent infarction in the tissues supplied. Overhang of the atlantal lateral masses and widening of the paraodontoid space will be associated. The greater occipital (C2) does not tend to do this, but emitting as it does between the posterior arch of the atlas and above the lamina of the axis, it refers pain to the vertex of the head. We make sure that our clients are in safe hands hence, we have tied up with the finest Cervical Spine Surgery Hospitals in Chennai, India where various surgical procedures related to spine are carried out by highly efficient cervical spine surgeons. Most authorities state that fractures of the anterior arch are rare, mininimally displaced, usually comminuted, and frequently require tomography to be detected. So, I have seen some results, but still continue to get a lot of pain in my teres major area where my armpit meets my back, as well as in my tricep and down my arm into my pinkie finger.
I also have pain on the top of my shoulder between my neck and my arm, but most of that is the tendonitis I think.
Do you have any suggessions I should bring to my doctor or opinions about Prednisone orally?



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Comments to “Cervical spine causes tinnitus”

  1. When we came down from the into the nerves of the cervical spine causes tinnitus inner ear the severity of his.
  2. Tuned to a distinct frequency, damaged or lost cells leave basis.


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