Cervical spine deformation

Introduction Cervical vertebrae deformation is one of the symptoms of cervical spondylosis. Cervical spondylosis, also known as cervical vertebra syndrome, is a general term for cervical osteoarthritis, proliferative cervical spondylitis, cervical nerve root syndrome, and cervical disc herniation. It is a degenerative pathological change. Based on the disease. In the early stage, the cervical intervertebral disc was degenerated, the water content of the nucleus pulposus was reduced, and the fibers of the annulus fibrosus were swollen and thickened, followed by glassy degeneration and even rupture. After cervical disc degeneration, the pressure resistance and tensile strength are reduced. When subjected to the gravity of the skull and the pulling force of the muscles of the head and chest, the degenerated disc can undergo localized or extensive bulging to the periphery, narrowing the intervertebral disc space, overlapping the articular processes, dislocation, and the longitudinal diameter of the intervertebral foramen. Become smaller.

Cause

The main pathological changes are: early cervical disc degeneration, decreased water content of the nucleus pulposus and fibrous swelling and thickening of the annulus fibrosis, followed by glassy degeneration and even rupture. After cervical disc degeneration, the pressure resistance and tensile strength are reduced. When subjected to the gravity of the skull and the pulling force of the muscles of the head and chest, the degenerated disc can undergo localized or extensive bulging to the periphery, narrowing the intervertebral disc space, overlapping the articular processes, dislocation, and the longitudinal diameter of the intervertebral foramen. Become smaller. As the traction resistance of the intervertebral disc becomes weaker, when the cervical vertebra moves, the stability between adjacent vertebrae decreases and the intervertebral instability occurs, the mobility between the vertebral bodies increases and the vertebral body has a slight slippage, which then appears Bone hyperplasia of the posterior facet joint, hook joint and lamina, degeneration of the ligamentum flavum and ligament, cartilage and ossification.

an examination

Related inspection

Spinal MRI examination of neck stiffness

First, the cervical spine test

The test of cervical spondylosis is a physical examination, without the aid of instruments. It includes:

1. Frontal flexion neck test: The patient's neck is flexed forward and rotated to the left and right. If there is pain in the cervical vertebra, it indicates that the cervical facet joint has degenerative changes.

2. Intervertebral foramen crush test (cylinder test): the patient's head is biased to the affected side. The examiner's left palm is placed on the top of the patient's head, and the right hand clenches the fist and gently rubs the left hand back. Then there is radiation pain or numbness of the limb, indicating that the force is transmitted downward. When the intervertebral foramen becomes smaller, there is root damage; for those with severe root pain, the examiner can use the hands to overlap on the top of the head and pressurize under the pressure to induce or aggravate the symptoms. A positive compression test occurs when the patient's head is in the neutral or posterior position and is referred to as the Jackson indenter test.

3. Brachial plexus traction test: The patient bows, the examiner holds the patient's head and neck with one hand, and the other hand holds the wrist of the affected limb, pushing and pulling in the opposite direction to see if the patient feels radiation pain or numbness. This is called the Eaten test. If the patient is forced to perform an internal rotation while pulling, it is called the Eaten strengthening test.

4. Upper limb extension test: The examiner is placed on the shoulder of the healthy side to fix the other hand, and the other hand is held on the wrist of the patient, and gradually stretches backward and outward to increase the traction of the cervical nerve root. Radiation pain in the affected limb indicates compression or damage to the cervical nerve root or brachial plexus.

Second, X-ray examination of cervical spondylosis

Men over 40 years of age, about 90% of women over the age of 45 have spurs of the cervical vertebral body. Therefore, there is a change in the X-ray film, which does not necessarily have clinical symptoms. The X-ray findings related to cervical spondylosis are now described as follows:

Orthotopic: Observe the presence or absence of pivotal joint dislocation, odontoid fracture or absence. Whether the seventh cervical transverse process is too long, with or without neck ribs. Whether the hook cone joint and the intervertebral space are widened or narrowed.

Differential diagnosis

Differential diagnosis of cervical spine deformation:

1, cervical disc herniation: cervical disc herniation is one of the more common clinical spinal diseases, the incidence is second only to lumbar disc herniation. Mainly due to the cervical disc nucleus, the annulus fibrosus, the cartilage plate, especially the nucleus pulposus, after different degrees of degenerative lesions, under the action of external factors, the intervertebral disc annulus ruptures, the nucleus pulposus tissue protrudes from the rupture or Peel out of the spinal canal, causing adjacent tissues, such as spinal nerve roots and spinal cord, to cause headache, dizziness; palpitations, chest tightness; neck soreness, limited mobility; shoulder and back pain, upper limb numbness and pain; gait loss Symptoms and signs such as weakness and weakness of the limbs. In severe cases, high paraplegia is life-threatening.

2, cervical spine degeneration: the process of degeneration of cervical spondylosis is a gradual process, cervical spine premature muscle strain, followed by degeneration, after the cervical spondylosis is formed step by step.

3, cervical vertebra hyperplasia: cervical vertebra hyperplasia refers to cervical degenerative lesions and bone hyperplasia oppression of the cervical spinal cord or cervical nerve root disease, also known as cervical syndrome, Chinese medicine is "bone callus", "chronic strain" category.

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