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Veterans' health care in the United States is separated geographically into 19 regions (numbered 1, 2, 4–10, 12 and 15–23) [1] known as VISNs, or Veterans Integrated Service Networks, into systems within each network headed by medical centers, and hierarchically within each system by division level of care or type.
In addition to spinal stenosis, other lower back conditions such as spondylosis, tumors, infections and herniated or ruptured discs can cause NC. These conditions contribute to the potential narrowing of the spinal cord, increasing pressure and inducing damage on the spinal nerve roots, thus, causing paing, tingling or weakness in the lower body.
In cervical spondylosis, a patient may be presented with dull neck pain with neck stiffness in the initial stages of the disease. As the disease progresses, symptoms related to radiculopathy (due to compression of exiting spinal nerve by narrowed intervertebral foramen) or myelopathy (due to compression on the spinal cord) can occur. [2]
A systematic review found moderate quality evidence that spinal manipulation is effective for the treatment of acute lumbar radiculopathy [17] and cervical radiculopathy. [18] Only low level evidence was found to support spinal manipulation for the treatment of chronic lumbar radiculopathies, and no evidence was found to exist for treatment of ...
The most common form of myelopathy in humans, cervical spondylotic myelopathy (CSM), [2] [3] also called degenerative cervical myelopathy, [4] results from narrowing of the spinal canal (spinal stenosis) ultimately causing compression of the spinal cord. [5] When due to trauma, myelopathy is known as (acute) spinal cord injury.
Such severe spinal stenosis symptoms are virtually absent in lumbar stenosis, however, as the spinal cord terminates at the top end of the adult lumbar spine, with only nerve roots (cauda equina) continuing further down. [15] Cervical spinal stenosis is a condition involving narrowing of the spinal canal at the level of the neck.
In some, the x-ray findings may correspond to symptoms of back stiffness with flexion/extension or with mild back pain. [2] Back pain or stiffness may be worse in the morning. [ 4 ] Rarely, large anterior cervical spine osteophytes may affect the esophagus or the larynx and cause pain , difficulty swallowing [ 5 ] [ 6 ] or even dyspnea . [ 7 ]
It was named by the Health Service Journal as one of the top hundred NHS trusts to work for in 2015. At that time, it had 1310 full-time equivalent staff and a sickness absence rate of 2.88%. 87% of staff recommend it as a place for treatment and 71% recommended it as a place to work. [8]
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