Degenerative changes c4-c7 with anterior listhesis of c4-c5
When these bony surfaces erode, the joints no longer can hold the two vertebrae in perfect alignment and a slip occurs. With both sides worn down, a forward slip called a degenerative spondylolisthesis will occur. If only one joint is worn and the other side remains intact, a rotary listhesis will occur a slip on the side of wear that rotates the vertebra above on the vertebra below. Instability can occur with this forward slip. Instability is the inability of the two vertebral segments to maintain normal alignment when exposed to the normal day to day forces that the neck is typically subject to.
Instability can cause local neck pain and endanger the nerve roots or spinal cord. The forward slip of the upper vertebra on the lower one has ramifications for the diameter of the spinal canal. Since the canal is a series of concentric rings piled perfectly one on top of another, the forward slide of the upper vertebra can significantly narrow the canal and potentially compress the spinal cord.
Because the volume of the canal, with or without this pinching will enlarge with forward bending and decrease in size with backward bending, you can imagine what happens to the canal that is already narrowed when you add backwards bending. This narrowing of the canal can cause compression of the cord and a condition called myelopathy-dysfunction of the spinal cord.
See this website for a description of these symptoms. With the presence of this narrowing, an impact onto the front of the head can cause a more significant compression of the cord called a central cord syndrome. See the website for further details of this injury. The erosion of these joints also causes increased bone spur production as the bone tries to compensate for instability by increasing its surface area. Ingrowth into areas that are quire sensitive such as the nerve root exit holes the foramen and the central spinal canal where the spinal cord lives is not uncommon.
Black arrows point to cervical facet. Degenerative spondylolisthesis arrow. Note the significant narrowing of the discs below the slip level. Typical degenerative spondylolisthesis in the cervical spine. Small arrows point to the very degenerative discs below the slipped level. The larger arrow points to the slip of C4 on C5. Note that with flexion bending forward , C4 moves forward on C5.
The motion puts the cord in jeopardy. Stenosis narrowing of the spinal canal in a degenerative spondylolisthesis. The arrow points to the slip level and the cord compression. The two lines indicate the back of C4 and C5.
Anatomy of the Joints and Cervical Degenerative Spondylolisthesis Overview
The two lines normally should align evenly. Degenerativ spondylolisthesis with cord injury. Large arrow points to slip level. Small arrow points to the cord injury where the slipped C6 vertebra impacted into the spinal cord. There is signal change of the cord whiter area indicating injury. There are two ways to consult with Dr.
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You can schedule an office consultation that should be covered by your insurance. Please keep reading below for more information on this condition. The most common symptom of a cervical degenerative spondylolisthesis is neck pain. With instability, painful popping and clicking and back of the neck pain can occur. However this condition may be present and painless. This painless condition can be a problem occasionally as rarely, a catastrophic injury may occur based upon a fall onto the head or neck and injure the nerve root or spinal cord.
Myelopathy can occur and its symptoms are well documented under the myelopathy category on this website. Shoulder and arm pain can occur when the nerve root is compressed. Treatment for cervical degenerative spondylolisthesis is based upon the symptoms, the amount of compression of the cord and nerve roots and the instability present.
In many cases, if there are no symptoms, and no threat to the cord, there is no need for treatment. If the patient has actual neck pain from the facet arthritis, physical therapy , chiropractic , medications , activity avoidance and facet injections can be helpful.
Everything you need to know about anterolisthesis
Chiropractic treatment manipulation is contraindicated if there is instability or a slip that creates compression of the cord and possibly nerve roots. If facet injections help but last only temporarily, dorsal facet rhizotomies can be effective see website. A rhizotomy is an outpatient procedure that attempts to desensitize the facet by burning the small sensory nerves that supply this joint. Surgical correction of cervical degenerative spondylolisthesis can be important.
If there is instability, cord compression, symptomatic nerve compression or significant neck pain, the proper surgery to correct this condition is an ACDF anterior decompression and fusion- see website.
Paraspinous: Paraspinal musculature is unremarkable. Cervical cord: No focal cord signal abnormality. Disc levelsC2-C3: Disc height is maintained. Disc desiccation. Some facet degenerative changes slight spurring encroaching into the neural forament. No significant central canal stenosis or foraminal narrowing. C3-C4: Disc height is maintained. No significant central canal stenosis. Facet degenerative changes more so on the left. Slight spurring encroaching into the neural foramen. C4-C5: Diminished disc height.
Slight posterior bony ridging and disc. This indents the ventral margin of the thecal sac and decreases the CSF space ventral to the cord. Uncovertebral joint degenerative changes on hte left and facet degenerative changes.
Some spurring encroaches into the left neural foramen. Canal minimally narrowed. C5-C6: Dimished disc height.https://imovucewybyt.tk
Cervical Stenosis, Myelopathy and Radiculopathy
More prominent posterior bony ridging and disc. This is seen pronounced centrally and right paracentrally. This indents the ventral margin of the thecal sac and effaces the CSF space ventral to the cord. Slight cord flattening is seen. Left-sided uncovertebral joint degenerative changes.
Slight encroachment into the neural foramen. Canal moderately narrowed. C6-C7: Diminished disc height. Posterior bony ridging and disc. This is prominent centrally and right paracentrally. This indents the ventral margin of the thecl sac and decreases the CSF space ventral to the cord. Uncovertebral joint degenerative changes more so on hte left. Some facet degenerative changes.
Canal mildly narrowed.