Cervical Red Flags

• D -

  Dizziness
• Diplopia


  Double Vision
• Dysphagia


  Swallowing
• Dysarthria


  Talking
• D -

  Drop Attacks
• N -

  Nausea
• Nystamus


  Eyes Flickering
• N -

  Facial Numbness
• Ataxia


  Unsteady / Uncontrolled Gait
• Stenosis


  Abnormally constricted body canal or passage
• Stenosis


  • Narrowing of the various foramen of the spine
• Causes of stenosis


  • Facet joint arthritis
  • Thickened ligaments
  • Tumor
  • Osteophytes
  • Scoliosis
  • Inflammation
  • Intervertebral disc injury
  • Spondylosis
  • Trauma
  • Spondylolisthesis
• Cervical artery dysfunction

  An umbrella term to cover a range of vascular pathologies that may lead to cervico-cranial ischaemia (including a stroke)
• Cauda equina syndrome

  Spinal cord compression of the cauda equina
• Cauda equina syndrome

  • Nerve roots that control the function of the bladder and bowel are compressed
  • Some patients may not recover complete function post surgery
• Risk factors for spinal metastatic cancer

  • Smoking, diet, radiation, sun exposure
• Primary cancers of the spine are rare
• Axial Spondyloarthritis


  Lifelong, systemic chronic inflammation of spinal entheses
• Spinal cord functions:

  • Sensory information from the body to the brain (afferent) • Motor control from brain to body (efferent) Includes bladder, bowel and sexual function • Autonomic function from brain to body • Spinal reflexes
• Cauda equina syndrome

  a rare and severe type of spinal stenosis where all of the nerves in the lower back suddenly become severely compressed. Symptoms include: sciatica on both sides. weakness or numbness in both legs that is severe or getting worse. numbness around or under your genitals, or around your anus. LMN involved and it is a neurosurgical emergancy
• Red Flags of Cauda Equina Syndrome

  Persistent Lower Back Pain

  Erectile Dysfunction (men only)

  Saddle Anaesthesia

  Impaired Bladder Function

  Impaired Bowel Function

  Bi lateral dermatomal changes

  Bi lateral myotomal changes
• Red flags for spinal malignancy/metastatic cancer

  • Systemically unwell (fever/chills/fatigue/malaise)
  • Unremitting, non-mechanical night pain
  • Change in bladder and bowel habits
  • Sores that do not heal
  • Unexplained weight loss (>5% in a four-week period)
• Red flags for axial spondyloarthritis (axial SpA)

  • Morning stiffness > 30 minutes
  • Eased with movement and NSAIDs
  • Family history of inflammatory conditions
  • Alternating sacroiliac joint pain
  • Possible uveitis (eyes)
  • Possible Crohn's/colitis (digestive)
  • Possible psoriasis (skin)
  • Possible enthesitis (tendon)
  • Dactylitis (swollen fingers)
  • Pitting and clubbing (nails)