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Monday, 25 November 2013

Cervical Stenosis with Myleopathy -The Symptoms, Causes and Risk Factors

Musculoskeletal disorders (MSDs) is medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. A community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home. Musculoskeletal pain was reported by 57% of those interviewed. A major restriction of joint movement range was frequent in the shoulder but uncommon in other joints. A shoulder disorder was found in 27% of subjects, rheumatoid arthritis in 1% and osteoarthritis (OA) of the hand, hip, and knee in five, seven, and 18% of subjects, respectively. Disability was frequent: a walking distance of < 500 m was found in 60% and ADL dependency in 40% of the group. Factors related to one or both of these disability measures included female gender, hip and knee OA, impaired vision, cognitive impairment and neurological disease(1).
V. Cervical Stenosis is defined as a degeneration of the structures of the spine as a result of aging causes of a slowly progressive condition of the cervical spinal cord. Spinal stenosis cause pressure on the spinal cord, which may lead to the symptoms of myelopathy. Cervical spinal stenosis with myelopathy is a common disease in elderly patients of male gender(2)
A. Symptoms
Symptoms are as of result of neurologic disease which can lead to progressive disability and eventual paralysis if without appropriate treatment, depending to the expression of the exact distribution of the myelopathy in the spinal cord. Most elders with Cervical Stenosis are experience painless symptoms, others may be experience one of more symptom, depending to the location of the compression and dysfunction of spinal cord.
1. Increased knee and ankle reflex may be a first sign of the disease
2. Tightness of gait and numbness of the legs, depending to the expression of the exact distribution of the myelopathy in the spinal cord of the individual patient, such as weakness, difficulty walking, frequent falls, etc.
3. Pins-and-needles (paraesthesia) sensation in the whole body.
4. Muscle weakness or paralysis
5. Deterioration in fine motor skills (such as handwriting or buttoning a shirt)
6. Intermittent shooting pains into the arms and legs (like an electrical shock), especially when bending their head forward (known as Lermitte’s phenomenon)
7. Arm and neck pain as a result of the myelopathy constitute a combination of cord failure at the affected level and of compression and irritation of the cervical nerve roots which leave the neck at this site, such as weakness, stiffness or clumsiness in the hands,
8. Loss of appreciation of temperature, pain and joint sense and often with impairment of bladder and bowel control, as a result of the transverse lesion of the spinal cord effecting modalities of cord transmission with spasticity of gait and increased tendon reflexes, in the later state of (3).
9. Etc.
B. Causes of risk factors
B.1. Causes
Cervical Stenosis with Myleopathy may be result of degenerative changes within the spine or bone spurs  of that can lead to the size of the spinal canal becoming smaller and bone spurs begin to press on the spinal cord or the nerve roots due to related to age, genetics, and wear and tear of daily living. Tumor located between the spinal cord and vertebrae can cause Cervical Stenosis with Myleopathy
B.2. Risk factors
1. Aging and gender
If you are male and over 50 years of age, you are at higher risk to develop Cervical Stenosis with Myleopathy.
2. Genetics
Congenital narrowing of the cervical spinal canal may result in cord compression without a history of injury and occasionally without evidence of significant bony degenerative changes(4).
3. Wear and tear of daily living
Tear and wear, injure can cause scar tissues and weaken the function of disc in absorbing shock, causing pressure on the spinal cord.
4. Injure
Injure to the spine can cause scar tissues which can weaken the spinal tissues, such as thickened ligaments.
5. Etc.

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References
(1) http://www.ncbi.nlm.nih.gov/pubmed/7864688 
(2) http://www.ncbi.nlm.nih.gov/pubmed/22426774
(3) http://www.saspine.org/conditions/cervical_spinal_stenosis_myelopathy.htm
(4) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC492191/