Cervical spondylosis

Introduction to cervical cervical spondylosis Cervical cervical spondylosis, also known as local cervical spondylosis, has pain in the head, shoulders, neck and arms and corresponding tender points. There are no obvious degenerative changes such as stenosis of the intervertebral space on the X-ray film, but there may be changes in the physiological curve of the cervical spine. Changes in intervertebral instability and mild bone hyperplasia. This type is extremely common in the clinic and is the earliest cervical spondylosis. Many patients who have repeatedly suffered from falls are such changes. This type is actually the initial stage of cervical spondylosis and the most favorable time for treatment. basic knowledge The proportion of illness: 0.04% Susceptible people: more young people Mode of infection: non-infectious Complications: stroke, neurasthenia, autonomic dysfunction, high paraplegia, deafness

The cause of cervical cervical spondylosis

Causes:

Due to degeneration of the cervical vertebrae, the nucleus pulposus and the annulus fibrosus dehydrate, degeneration, directly stimulate the sinus nerve endings and cause disease.

Age factor (15%):

With the increase of age, the wear of various parts of the human body is also increasing, and the cervical vertebrae will also produce various degenerative changes, and the degenerative changes of the intervertebral disc are the most important reasons for the development of cervical spondylosis.

Improper working posture (20%):

In particular, the incidence of cervical disc herniation in long-term low-head workers is extremely high. In addition, some inappropriate physical exercise will also increase the incidence rate, such as illegal standing, tumbling and so on.

Chronic strain (25%):

Refers to the damage caused by excessive activities beyond the normal range, such as poor sleep, improper height of the pillow or improper position of the pad, and the prevalence of repeated stiff neck is also higher.

Trauma (20%):

On the basis of degeneration and instability of the cervical spine, the trauma of the head and neck is more likely to induce the occurrence and recurrence of cervical spondylosis.

Mental factors (5%):

From clinical practice, it is found that bad mood often makes cervical spondylosis worse, and the symptoms of cervical disc herniation are more serious.

Pathogenesis:

In the initial stage of cervical degeneration, the main manifestations are dehydration of the nucleus pulposus and annulus fibrosus, degeneration and local tension of the vertebral joint, which in turn causes loosening and instability of the intervertebral space. The symptoms of the patient are often in the morning, overwork, and posture is not correct. And after the cold stimulation suddenly increased, the instability of the vertebral joint not only caused the internal and external balance of the cervical vertebrae and the defensive tendon of the cervical muscle, but also directly stimulated the sinus nerve endings distributed in the posterior longitudinal ligament and the lateral root sleeves, causing the neck Most of the symptoms, local pain, neck discomfort and limited mobility, a few cases may have a transient upper limb (or hand) symptoms due to reflex, the scope of which is consistent with the affected vertebrae, when After the body establishes a new balance through the adjustment and compensation, the above symptoms gradually disappear. Therefore, most cases may heal themselves, or only take general measures to relieve or even disappear the symptoms. In the later large spinal canal, the pathological changes are more complicated. In addition to the above pathophysiological changes, pathological changes such as vertebral hyperosteogeny and osteophyte formation may be associated.

Cervical cervical spondylosis prevention

The office staff should first maintain a natural sitting position in the sitting position, the buttocks and the back should fully contact the seat surface, the shoulders are extended, the shoulders are parallel with the edge of the table, the spine is straight, and the two feet are on the ground. Adjust the height of the table and chair to the best condition in proportion to your height, so that you can look at the computer screen and relax your shoulders. Avoid excessive flexion or excessive back-up of the head and neck to relieve neck fatigue caused by long sitting.

1. Sitting posture is correct: To prevent the occurrence of cervical spondylosis, the most important thing is to sit correctly, relax the neck and shoulders, and maintain the most comfortable and natural posture. Office workers should also stand up and move around from time to time, moving the neck and shoulders to relax the muscles of the neck and shoulders.

2. Active neck: Should work for 1 to 2 hours, purposefully let the head and neck rotate forward and backward several times, and the rotation should be gentle and slow, in order to achieve the maximum range of motion in all directions. The cervical joint fatigue is alleviated.

3. Looking up and looking at the distance: When looking at things for a long time, especially in the state of bowing, it affects the cervical vertebrae, and it is easy to cause visual fatigue and even induce refractive error. Therefore, whenever the desk is too long, you should look up and look at the distance for about half a minute. This will not only eliminate fatigue, but also help the health of the cervical spine.

4. Sleep mode: Do not sleep while sleeping, pillows should not be too high, too hard or too low. Pillow: The center should be slightly recessed, the neck should be in full contact with the pillow and stay slightly back, do not hang. Those who are used to the lateral position should have the pillows shoulder height. When you sleep, don't lie down and read a book. Don't blow cold wind to the head and neck.

5. Avoid injury: Avoid and reduce acute cervical spine injuries, such as avoiding heavy lifting, emergency braking, etc.

6. Cold and moisture proof: prevent cold and dampness, and avoid cold and cold when bathing at midnight and early morning. Patients with cervical spondylosis are often closely related to seasonal climate changes such as cold and humidity. Wind chills cause local blood vessels to contract, and blood flow velocity is reduced, which hinders tissue metabolism and blood circulation. In the winter, you should wear a scarf or a high-neck sweater to prevent the neck from being exposed to the wind and cold.

7. Prevention of infection: Active treatment of neck infections and other neck diseases.

Cervical cervical spondylosis complications Complications, neurasthenia, autonomic dysfunction, high paraplegia, deafness

1. Stroke: According to incomplete statistics, more than 90% of stroke patients have cervical spondylosis, but many people do not pay attention. After the stroke, they do not know, especially many doctors do not understand;

2, stubborn insomnia, neurasthenia: more than 70% of people with this disease have cervical spondylosis. Many patients and doctors can only treat insomnia blindly;

3, repeated episodes of dizziness: mainly caused by vertebral artery compression, if you work in high places, walking along the river, driving on the road, the machine suddenly fainted when operating, it will bring very serious consequences;

4. Severe memory loss;

5, the neck stiffness can not be rotated;

6, autonomic dysfunction;

7, upper limb pain is weak;

8, high paraplegia;

9, deafness.

Symptoms of cervical cervical spondylosis Common symptoms Forced posture Head and neck activity Restricted shoulder aching pain Cervical degeneration occipital pain Cervical ischemic jumping neck Cervical hyperplasia Cervical pain Cervical joint root pain Pain hypertrophy

1. Age of onset: It is more common in young adults, but it is the first time after 45 years of age for those with larger sagittal diameter of the spinal canal.

2. Incidence time: In addition to the morning when it is more common (related to the higher pillow or improper sleep posture), it is often seen after a long period of low-head work or study, indicating a direct correlation with the increase in pressure in the intervertebral disc space.

3. Common symptoms: mainly neck acid, pain, swelling and discomfort, especially patients often complain that the head and neck do not know where to put it, about half of the patients have restricted neck activity or forced position, individual cases The upper limbs may have a transient paresthesia.

4. Check what you see: the neck is more "striker standing", that is, the neck is straight, the physiological curvature is weakened or disappeared, and there may be tenderness between the spinous process and the spinous process, which is generally light.

Examination of cervical cervical spondylosis

When the neck is naturally straightened, the physiological curvature is weakened or disappeared. Some people have partial hemiplegia, normal or slightly restricted activity, and the neck muscles are paralyzed and scattered at the tender point.

The neck palpation can detect tenderness between the spinous processes and both sides of the affected section, but it is lighter and more radiation-free. In addition, the indenter test and the brachial plexus pull test were negative.

X-ray examination except that the cervical curvature of the cervical vertebrae became straight or disappeared, the orthotopic slice showed that the adjacent hook joints were not equal in width, and about 1/3 of the cases had loose intervertebral space on both sides of the stress. In a few cases, vertebral marginal hyperplasia and ligament calcification can be seen, but some patients have only cervical physiologic changes.

Diagnosis and diagnosis of cervical cervical spondylosis

Diagnostic criteria

1. Clinical features: Mainly complaining of neck, shoulder and occipital pain and other paresthesia, accompanied by corresponding tender points and neck stiffness.

2. Imaging changes: X-ray film shows changes in cervical curvature, cervical lateral dynamics can show intervertebral joint instability, loose and trapezoidal changes (earlier than magnetic resonance imaging); MRI shows disc degeneration Or after the sudden levy.

3. Except for other diseases: mainly except for neck sprains, inflammation around the shoulder joints, rheumatoid muscle fibrosis, neurasthenia and other neck and shoulder pains caused by cervical disc degeneration.

Differential diagnosis

Cervical cervical spondylosis is easily confused with many patients and should be taken seriously. It is now described later.

Neck sprain

(1) Overview: The neck sprain, commonly known as the stiff neck, is caused by sprain of the neck muscle, because its incidence is similar to that of cervical spondylosis, more than the onset in the morning, so the two are easily confused, and even some physicians inappropriately Treating the two as the same kind of disease, the cause of neck sprain is mostly due to the poor neck position during sleep, so that the local muscle is sprained, which is completely different from cervical cervical spondylosis caused by degeneration of the intervertebral disc. Therefore, In the treatment, patients with cervical cervical spondylosis are mainly treated with traction therapy. For patients with cervical sprains, traction is not only ineffective, but can aggravate the condition. Therefore, the two should be identified.

(2) Identification points: mainly based on the following four points:

1 tenderness point: the tenderness point of patients with cervical cervical spondylosis is more common in the spinous process and on both sides of the paravertebral, the degree is lighter, the patient with hand pressure can tolerate, and the pain range is consistent with the affected nerve root distribution area, and the stiff neck The tenderness point of the person is seen in the local part of the muscle injury. It is more common in the upper part of the shoulder blade on both sides. The pain in the acute phase is severe and the pressure is often unbearable.

2 muscle spasm: patients with cervical cervical spondylosis are generally not accompanied by neck muscle spasm, while those with sprained neck can touch the cord-like muscle bundle with obvious tenderness.

3 Response to the traction test: When the examiner uses a little force to pull the patient's head and neck upwards, the cervical spondylosis patients have symptoms disappeared or relieved, while the neck sprains have increased pain.

4 response to closed therapy: 5% of 1% procaine for pain point closure, cervical spondylosis patients with no significant, and neck sprains immediately disappeared or significantly relieved.

Based on the above, the authentication list of the two is listed.

2. Surgery around the shoulder joint

(1) Overview: inflammation around the shoulder joint is also known as "frozen shoulder". Because it is more than 50 years old, it is also called "fifty shoulders". Its age is similar to that of cervical spondylosis, and it is often accompanied by neck. The symptoms are confusing, but because the treatment methods of the two are obviously different, they should be identified.

(2) Identification points of cervical spondylosis:

1 Pain point: The pain caused by cervical cervical spondylosis is mostly centered on the spinous process and paravertebral; the pain of patients with inflammation around the shoulder is mostly limited to the shoulder joint and its surroundings.

2 range of shoulder joint activity: cervical cervical spondylosis generally does not affect the shoulder activity; while the shoulder joint activity range of patients with periarthritis of the shoulder is obviously limited, especially during the exhibition, it is "frozen".

3 Responses to acupuncture therapy: For patients with cervical spondylosis, patients with cervical spondylotic vertebral disease can be immediately treated with acupuncture at the three-needle acupoints or through the mountain. Acupuncture points are effective.

4 imaging examination: X-ray plain film of patients with cervical spondylosis can show that the physiological curvature of the cervical vertebra disappears, and there may be a trapezoidal change on the dynamic lateral radiograph; while the periarthritis of the shoulder joint generally does not have this phenomenon, if necessary, refer to MRI results.

In addition to the above four identification points, we can refer to the response to closed therapy and shoulder massage therapy, etc., in the inflammation around the shoulder joints, such treatments are effective, in addition, the disease should be compared with cervical spondylotic radiculopathy Identification.

3. Rheumatic myofibrillar tissue

(1) Overview: Rheumatoid muscle fibrosis is a chronic disease, which is mostly related to cold, dampness, etc. Except for the neck and shoulders, it can occur all over the body, and in addition to the neck and shoulder, the lumbosacral region is also more common. Muscle fibrous tissue in the neck and shoulder needs to be differentiated from cervical cervical spondylosis.

(2) Identification points:

1 systemic manifestations: patients with rheumatoid muscle fibrosis have general characteristics of rheumatism, such as systemic joints, muscle soreness (may have migration), pharyngeal redness (inflammation of the tonsils), increased erythrocyte sedimentation rate, rheumatoid The factor-positive and anti-streptolysin O assays were more than 500 U.

2 local symptoms: local symptoms of rheumatoid muscle fibrosis patients mostly with soreness, a wide range, fear of cold, more than fixed tenderness, and have a comfortable feeling.

3 Others: According to the patient's morbidity, predisposing factors, medical history, previous response to anti-rheumatic drug treatment and X-ray film findings.

4. Other diseases

All diseases that can cause neck pain and discomfort should be diagnosed, especially various congenital malformations of the spine itself, inflammation (more tuberculosis), etc. Therefore, all patients complaining of neck symptoms should be routine. Taking a positive lateral X-ray film, first of all, except for various organic diseases that can be displayed on the X-ray film, especially for those who plan to practice massage, to prevent accidents, and then decide whether to do MRI or CT examination. In order to further understand and master the disease, and finally make a diagnosis.

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