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 click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. 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 Username Error: Please enter User Name Password Error: Please enter Password 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 a profile for additional features.