Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Spinal osteoarthritisCervical spondylosisThoracic spondylosisLumbar spondylosis ++ 721 Spondylosis and allied disorders721.0 Cervical spondylosis without myelopathy721.1 Cervical spondylosis with myelopathy721.2 Thoracic spondylosis without myelopathy721.3 Lumbosacral spondylosis without myelopathy721.4 Thoracic or lumbar spondylosis with myelopathy721.41 Spondylosis with myelopathy, thoracic region721.42 Spondylosis with myelopathy, lumbar region721.9 Spondylosis of unspecified site721.90 Spondylosis of unspecified site, without myelopathy721.91 Spondylosis of unspecified site, with myelopathy ++ M47.12 Other spondylosis with myelopathy, cervical regionM47.14 Other spondylosis with myelopathy, thoracic regionM47.16 Other spondylosis with myelopathy, lumbar regionM47.812 Spondylosis without myelopathy or radiculopathy, cervical regionM47.814 Spondylosis without myelopathy or radiculopathy, thoracic regionM47.817 Spondylosis without myelopathy or radiculopathy, lumbosacral regionM47.819Spondylosis without myelopathy or radiculopathy, site unspecified ++ 4B: Impaired Posture4D: Impaired Joint Mobility, Motor Function, Muscle Performance, and Format Range of Motion Associated with Connective Tissue Dysfunction4E: Impaired Joint Mobility, Motor Function, Muscle Performance, and ROM Associated with Localized Inflammation +++ Description ++ Osteoarthritis of the spineChronic degenerationProgressive arthritis of the spinal jointsAs the space between the vertebrae decreases, there can be compression onto the nerve rootsArthritis can be central or lateral foramen basedCentral: usually bilateral symptomsLateral: usually unilateralPain, paresthesia, and weakness in the extremitiesPressure on the nerve root can cause radiculopathy. +++ Essentials of Diagnosis ++ X-rayAcute painful flare-ups, chronic persistent painRelief with NSAIDsMorning stiffness +++ General Considerations ++ Begins with pain that is intermittentPain and stiffness at rest/sleepImproved with low-level activityCould have rapid and severe onsetSecondary problem is vertebrobasilar insufficiency +++ Demographics ++ Common in adults ages 60 and older +++ Signs and Symptoms ++ FatigueStiffnessHeavinessLoss of ROM and joint playPain that is intermittent, increased with weight-bearing activitiesParesthesiaTingling sensation in the extremityDiminished reflexesLower motor neuron dysfunctionMuscle weaknessRadiculopathyCharacteristics of the different syndromes of cervical spondylotic myelopathy +++ Functional Implications ++ Limited mobilityIncreased symptoms with increased weight-bearing exercisesAerobic endurance limitation +++ Possible Contributing Causes ++ Family history of osteoarthritisBone spursInstabilityWeaknessPoor postureLimited flexibility +++ Differential Diagnosis ++ Spinal stenosisDisc herniationForestier diseaseReiter’s syndrome (reactive arthritis)Whipple’s diseaseYersinia arthritisFacet joint arthritisPsoriatic arthritisRheumatoid arthritis +++ Imaging ++ X-ray spine and pelvisMRI of the spine ++ Decreased space on x-ray between the vertebrae +++ Medication ++ NSAIDsCorticosteroids ++ Rheumatologist to assess underlying complicationsSurgical consultOrthopedic surgeon ++ MobilityFunctional rotation and bending ++ Straight ... 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.