Cervical and Lumbar Stenosis Graded +

Cervical and Lumbar Stenosis Graded + What is stenosis? "The abnormal narrowing of a passage in the body" What are the locations of spinal stenosis? - Central canal - Foraminal - Lateral recess stenosis What are the abnormal measurements that indicate spinal stenosis? - Vertebral canal is normally 15mm - 13mm suggests stenosis - 10mm is definite narrowing What is the spinal / vertebral canal affected by, that would result in stenosis? - Posterior disc bulges - Disc herniations - Bony osteophytes - Ligamentum flavum hypertrophy What is the preferred method to evaluate potential stenosis? Axial slices of a CT or MRI Degenerative Joint Disease is a common cause of spinal stenosis, what can DJD be in relation to its own causes? - Primary (idiopathic - no specific cause identified) - Secondary to trauma/infection/developmental anomaly (alters shape) What is primary osteoarthritis? A chronic degenerative disorder of joints related to aging What happens during aging that causes primary osteoarthritis? As a person ages, water content of cartilage decreases as a result of a reduced proteoglycan content causing cartilage to be less resilient What happens to bony cartilage when there is a reduced proteoglycan content? Collagen fibers of cartilage can become susceptible to degradation and exacerbate the degeneration How is inflammation caused in primary osteoarthritis? Joint capsule can inflame due to breakdown products of cartilage being released into the synovial space, and the cells lining the joint attempting to remove them. Can also cause local joint pain, stiffness and swelling How are osteophytes formed in the spine? Bony outgrowths can form on the margins of joints, possibly in an attempt to improve congruence of articular cartilage surfaces What is the pathophysiology of degenerative disc disease? - Rate of proteoglycan synthesis reduces with increasing age - Chondroitin Sulphate falls - Nucleus becomes more fibrous, dry and unable to bind water - Nucleus can start to form cracks and fissures What are the risk factors of degenerative disc disease? - Mechanical load - Genetics - Poor end-plate vascularity due to smoking - Metabolic disorders such as diabetes What are the typical findings associated with DDD?