Spondylosis/OA definition etc

Cards (8)

  • Spondylosis/OA:
    • describes degenerative changes in Intervertebral discs, intervertebral bodies and facet joints of the spine
    • Can progress onto foraminal and canal stenosis, degenerative spondylitis or cauda equina syndrome
    • lumbar region most effected - high exposure to mechanical stress on how load goes through the spine
    • Normal process of aging: 80 - 90% of individuals between 45 - 60 yrs demonstrate osteophytes in lumbar spine so can be diagnosed with secondary illness
    • Not always painful - degenerative changes may present in younger pts without any trauma or history there should be a problem
    • the degenerative process in which OA mainly affects the lumbar spine is through affecting the vertebral bodies, the intervertebral foramen and the facet joints
  • Lumbar Joints:
    1. Increased in load on joints, esp facet joints
    2. Subchondral bone hypertrophy
    3. Osteophyte formation
    4. Disc/cartilage degeneration
    5. Inflammatory mediatorsNociceptor activation (may not always be present if theres no current/ongoing inflammation within the joint)
  • Clinical Presentation of Spondylosis / OA - History and MOI:
    • Insidious onset LBP: pain is vague and often non specific
    • Could also be secondary to trauma
    • pts maybe 55 yrs +
  • Clinical Presentation of Spondylosis / OA - Subjective Features:
    • Can present without paraesthesia/anaesthesia/red flags, but beware of a progressing pathology - always ask special questions
    • Morning stiffness lasting less than 30 minutes
    • Aggs: prolonged sitting (due to intervertebral disc degeneration) and standing (facet joint OA)
    • Eases: walking
  • Clinical Presentation of Spondylosis / OA - Objective Features:
    • Decrease in ROM - due to stiffness
    • Poor quality of movement - due to osteophytes formation
    • Stiff end feel - feature of arthritic joints
    • Posture? - any changes due to decrease ROM?
    • Could have neurological changes if progressive
  • Clinical Presentation of Spondylosis / OA - Key impairments:
    • Unable to sit for a long time / aggravators in resting positions
    • Pain
    • Reduced ROM - probably mostly when leaning forward or backwards
  • Clinical Presentation of Spondylosis / OA - Does this patient warrant a scan?
    • if we thought they had any red flags
    • if we thought they had any neurological signs and symptoms and if they were progressive