Page 122 - ASOP ROT Study Guide

Clinical presentation
The condition occurs typically in people who are over forty and is more frequent in females than males.
They have with dull neck ache which is often referred to the shoulders and upper arms. They also may
experience tingling in the arms which is often assumed to be an entrapment of nerve roots, but this is not
always confirmed on investigation. The spondylitic process can however be progressive and bony root
entrapment may occur, with localizing neurological signs.

Management
If there are no localizing neurological signs, treatment consists of analgesics, non steroidal anti-
inflammatory (NSAI) agents, the use of a soft collar, and physiotherapy to relieve muscle spasm.
Patients need counselling and a good explanation of the condition. They need to be warned that it is
usual, as in the lumbar spine, for recurrent attacks to occur.

If nerve root entrapment is confirmed, surgical fusion of the vertebrae and decompression of the nerve
root may be necessary.

5 . 2 Cervical Disc Disease

Clinical presentation
Although not as frequent, cervical disc disease has a similar pattern to that found in the discs of the lumbar
spine. The lower cervical discs are most likely to cause the problem. Symptoms of pain and referred
pain are similar to those caused by spondylosis. Differentiating between the conditions can be difficult,
although sufferers from disc disease tend to have no previous history of neck trouble. Also, following
disc prolapse, the neck muscles may be in spasm and the movement of the neck is severely restricted.

Management
Most people recover with resting, gentle traction and wearing a supporting collar. If localizing signs are
marked, or symptoms do not regress, then surgery and fusion of the affected vertebrae may be
necessary.