Dr Adriaan Liebenberg My Spine Explained | Page 38

My Spine Explained
At the same time the arthritic changes in the joints and abnormal alignment
of the spine cause local nerve and muscle irritation which leads to muscle
spasm and referred pain. The combination of enlarged facet joints, disc her-
niation, osteophytes and spinal ligament enlargement leads to narrowing of
the spinal canal.
Cervical osteoarthritis and abnormal alignment is called cervical spondylosis.
When the spinal canal is narrowed and the spinal cord is being compressed,
it leads to dysfunction of the nerves of the spinal cord.
What are the symptoms?
Compression of nerve roots causes pain and sensory abnormalities (pins and
needles) in the arm(s) and weakness of the arm muscles supplied by those
nerves. This is called radiculopathy. The dysfunction of the spinal cord as a
result of compression is called myelopathy. Myelopathy is a disease of the
spinal cord that manifests as pain and weakness in the arms and also spastic-
ity of the arms. The early manifestations can often be the inability to perform
intricate tasks with the hands and fingers and stumbling when walking. It can
also cause dysfunction of the nerves to the bladder and the bowel.
How is it diagnosed?
A clinical examination by your specialist or therapist will allow for a reason-
able suspicion, but the only definite way is by doing a magnetic resonance
imaging (MRI) scan. Sometimes, because of technical factors, a CT scan is
performed. This is usually when an MRI scan cannot be performed due to the
unavailability of an MRI scanner, when there are contra-indications to doing
a scan or when technical factors such as the presence of certain metal fusion
apparatus in the spine make an MRI scan unreliable.
Other tests that might be used are discograms and nerve blocks. Sometimes
electromyograms (EMGs) are also used.
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