Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Cervical spondylolysis ++ 738.4 Acquired spondylolisthesis ++ M43.00 Spondylolysis, site unspecified ++ 4E: Impaired Joint Mobility, Motor Function, Muscle Performance, and ROM Associated with Localized Inflammation +++ Description ++ Stress fracture of the pedicles on the vertebra belowTightness or pain in the neck regionOften no symptomsWeakness in the pars +++ Essentials of Diagnosis ++ Diagnosis made by X-rayCan be acquired or congenitalNeck pain +++ General Considerations ++ InstabilityAvoid extension positions that increase symptomsThin vertebral bone: pars +++ Demographics ++ Teenagers with high risk activities are more at riskRuns in families +++ Signs and Symptoms ++ Pain in cervical spine, shoulder, arm, upper extremityStiffness along spineHeadachesPain in cervical spine worsens with extension +++ Functional Implications ++ Difficulty sustaining standing postures secondary to neck and arm painInability to sleep flat on the back without a pillowDifficulty with movements (reaching overhead) secondary to pain Limit sports participation +++ Possible Contributing Causes ++ Forceful extension from hit under the chin (sports)CongenitalCar accident, hit from rearHyperextension of the cervical spineIncreased cervical lordosis posture +++ Differential Diagnosis ++ Peripheral nerve impairmentSpinal tumorPeripheral neuropathyParaspinal spasmsDegenerative disk diseaseStenosis +++ Imaging ++ MRI helps to visualize compressed or inflamed nerve root in diagnosisX-ray/plain-film radiograph to see vertebra positionCT scan to show herniation compressing the spinal canal/nervesElectrodiagnostic/nerve conduction testing can help to determine a specific impaired nerve function ++ Stress fracture of the pars ++ For imagingFor surgical consult if myelopathy is suspectedFusionDecompressionLaminectomyHemilaminectomyFor corticosteroid injection, anti-inflammatory medicationFor halo vest traction device, cervical bracing ++ Restricted mobility of the upper cervical spineHypermobilityWeakness noted of neck musculature ++ RestBracingAddress PainElectrical stimulationHeat/iceAddress hypertonicitySoft-tissue massageHeatAddress muscle weaknessStability exercises ++ Patient will be able to Sit with neutral cervical spine posture for greater than 30 minutes with 0 out of 10 pain ratingStand at work station and perform computer work for 45 minutes with 0 out of 10 pain ratingRotate cervical spine 75 degrees so as to look over the shoulder while driving the car with 0 out of 10 pain rating ++ Fair to good depending on severity of vertebral translation, amount of nerve-root compression, and upper/lower-extremity impairments ++1. The American Physical Therapy Association. Pattern 4E: Impaired Joint Mobility, Motor Function, Muscle Performance, and Range of Motion Associated With Localized Inflammation. Interactive Guide to Physical Therapist Practice 2003. ... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.