Deshmukh Siddhant S, Harjpal Pallavi
Department of Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Department of Neuro-Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Cureus. 2024 Aug 26;16(8):e67789. doi: 10.7759/cureus.67789. eCollection 2024 Aug.
Compression of the spinal cord at the cervical level of the spinal column is the hallmark of the disorder known as cervical myelopathy. The aberrant reflexes, hyperreflexia, pathologic reflexes, clumsiness in the hands and fingers, and disturbance of the gait are caused by this compression. It usually starts slowly, increases gradually, and eventually results in a functional decline. For patients older than 55, the most common cause of spinal cord dysfunction is cervical spondylotic myelopathy (CSM). The traditional definition of the pathogenesis of CSM is multilevel spondylosis, where osteophytes develop as a consequence of disc degeneration. The connection between myelopathy and increasing cervical kyphosis, however, has not received much attention. Myelopathy develops as a result of the kyphosis pushing the spinal cord against the vertebral bodies, causing disease in the anterior cord and increasing longitudinal cord strain because of the cord's tethering by the cervical nerve root and dentate ligaments. Because schwannomas in the carotid area are located close to important neurovascular structures, they can provide particular diagnostic and treatment issues. This case report focuses on the management of a rare condition of CSM and carotid space schwannoma by various neurophysiotherapy approaches over six weeks of rehabilitation.
脊柱颈椎水平的脊髓受压是称为颈椎脊髓病的疾病的标志。这种压迫会导致异常反射、反射亢进、病理反射、手部和手指笨拙以及步态紊乱。它通常起病缓慢,逐渐加重,最终导致功能衰退。对于55岁以上的患者,脊髓功能障碍最常见的原因是脊髓型颈椎病(CSM)。CSM发病机制的传统定义是多节段脊柱退变,其中骨赘是椎间盘退变的结果。然而,脊髓病与颈椎后凸增加之间的联系并未受到太多关注。脊髓病是由于后凸将脊髓推向椎体,导致脊髓前部病变,并由于颈神经根和齿状韧带对脊髓的束缚而增加脊髓纵向张力所致。由于颈动脉区的神经鞘瘤位于重要神经血管结构附近,它们会带来特殊的诊断和治疗问题。本病例报告重点介绍了通过六周康复期的各种神经物理治疗方法来管理一种罕见的CSM合并颈动脉间隙神经鞘瘤的情况。