Clinicians Perceptions of Minor Cervical Instability

Clinicians perceptions of minor cervical instability

Niere and Torney (2004)

Instability of the cervical spine leads to bony impingement or compression of neural or vascular structures. Which can lead to severe pain and neurological signs and symptoms or vascular compromise.

Diagnosis requires subjective and objective assessment and imaging for confirmation.

It has been proposed that cervical instability may exist where there is pain and disability due to the lack of control over the neutral zone, without compromise of the neural and vascular structures = Mild cervical instability

Clinical features may be subtle with mild cervical instability (MCI) and can include neck pain, complaints of catching and locking, weakness, poor muscular control, altered range of motion and a history of trauma. Loose end feel has also been described.

Retraining of the neural and muscular subsystems has been proposed as a treatment.

The purpose of this study was to identify what clinical finding were interpreted as usefull in the diagnosis of MCI.

153 Australian physiotherapists with post grad qualifications fiolled out a questionnaire that required them to rate the importance of 15 clinical findings in the diagnosis of MCI.

The most important factors and findings that indicated MCI were a *history of major trauma *reports of the neck catching, locking or giving way *poor muscular control *signs of hypermobility on X-ray *excessive end feel on passive motion testing

A history of Spondylolisthesis and repeated micro-trauma were also ranked as being very important.