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S/S disc pressing on dura mater
- Pain as high as head
- As lat as shoulder
- As caudal as inferior angle of scap
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D4 torticollis
- Unilat scapular ache
- Looking down and away
- Pt normally gets better very quickly, unless fx is cause
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Jefferson fx
Comminuted fx of ant and post arch of atlas (C1) due to axial loading
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Best imaging for Jefferson fx
CT axial
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S/S cervical fx
- Severe central or bilat neck pain
- Capsular pattern, spasm end field
- Possible neurological findings
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Clay shovellers fx
- Fx of C6, C7- or T1 SP
- Weak and Painful neck motion and cant lift arms above 90
- Capsular pattern
- Pain with spinal percussion test
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Spinal percussion test
- Flex spine and tap SP with reflex hammer
- SP fx
- Interspinous lig sprain
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Lateral recess stenosis
- Stenosis at beginning of foramen
- LMN symptoms, many have weakness
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Cervical myelopathy causes
- 1. Spondylitis (arthritis)
- 2. Spondylolisthesis
- 3. Disc lesion
- 4. Tumor
- 5. Congenital
- 6. Hypertrophy of ligamentum flavum or post long lig
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Cervical myelopathy presentation
- 1. Insidious onset
- 2. >55
- 3. central or bilat neck pain
- 4. + Hoffman, Lhermitte’s
- 5. paraesthesia caudal to LOL
- 6. diminished sensation and strength
- 7. spastic B/B
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Lhermitte’s sign
neck flexion cause tingling in arm
-
presentation of SC compression above L2
UMN
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Presentation of SC compression below L2
LMN
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Swallow test
- Anterior osteophyte
- Tumor/disc lesion
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