Cervical spondylosis
I. Definition of cervical spondylosis.
Degenerative changes of the cervical disc tissue (or intervertebral joint) and its secondary pathological changes involving the surrounding tissue structures (nerve roots, spinal cord, vertebral artery, sympathetic nerve, etc.), with corresponding clinical manifestations, are called cervical spondylosis (Cervical Spondylosis). This definition includes three basic elements: cervical disc degeneration or intervertebral joint degeneration; involvement of the surrounding tissues; and the appearance of corresponding clinical symptoms.
Second, the typology of cervical spondylosis.
According to the different clinical manifestations of the affected tissue structure is divided into: cervical type, nerve root type, spinal cord type, vertebral artery type, sympathetic type and others.
Third, the symptoms of cervical spondylosis: the clinical manifestations of cervical spondylosis are various
The typical clinical symptoms are: pain or numbness in the neck and occipital area or neck and shoulder, persistent or paroxysmal and radiating to the upper limbs and fingers, accompanied by pins and needles or electric-like numbness, and the pain and numbness can be increased when the neck is active or when coughing, sneezing or exerting a little force; at the same time, there can also be muscle atrophy of the upper limbs, sinking At the same time, there can be muscle atrophy of the upper limbs, sinking, soreness and weakness, inflexibility of movement, etc. At night, the pain in the neck and shoulders and upper limbs may be more severe, and you can toss and turn and cannot sleep.
2, due to stimulation and compression of the cervical spinal cord or stimulation and compression of the arterial vessels of the spinal cord, the blood supply to the spinal cord is insufficient, resulting in the dysfunction of the spinal cord, which can lead to spinal cord cervical spondylosis, whose typical clinical symptoms are: progressive numbness of the limbs, weakness, stiffness, inflexibility, walking on cotton, or even tetraplegia, feeling of the chest or abdominal straps, difficulty in urination and defecation or Incontinence, etc.
The typical clinical symptoms of sympathetic cervical spondylosis are: headache or migraine, dizziness, nausea, vomiting, unclear and blurred vision, decreased visual acuity, dilated or narrow pupils, posterior eye distension, rapid heartbeat, arrhythmia, anterior heart pain, increased blood pressure, abnormal sweating in the head and neck and limbs, tinnitus, hearing loss, dysarthria, etc. It can also be complicated by blurred eyes, tearing, nasal congestion, bradycardia, decreased blood pressure, gastrointestinal distention, etc.
4, due to the stimulation or compression of the vertebral artery in the neck, vertebral artery type cervical spondylosis can occur, and its typical clinical symptoms are mainly manifested as: episodic vertigo, sudden amblyopia or blindness, diplopia, etc., but it can recover in a short period of time, and sudden falls and other manifestations can occur. And most of these symptoms occur when the head is suddenly rotated or when it is flexed and extended. It can be seen that the clinical manifestations of cervical spondylosis are exceptionally complex and diverse.
Fourth, the treatment of cervical spondylosis.
1.Non-surgical treatment of cervical spondylosis
(1) Cervical epidural closure
It is generally believed that cervical epidural closure has certain efficacy for all types of cervical spondylosis except spinal cord type. It has also been reported that this method is also effective for spinal cervical spondylosis, but the effect is not consolidated.
(2) Traction and manipulative therapy
It is also widely used, but X-ray examination should be performed before manipulation, and if there is obvious segmental instability, cervical spinal stenosis and OPLL, it should be regarded as a contraindication to manipulation.
(3)Symptomatic treatment
Relieve the patient’s pain, such as anti-inflammatory pain.
(4)Others
Strict bed rest is very important treatment in the acute stage, and various physiotherapy is also a better adjuvant treatment.
2.Surgical treatment of cervical spondylosis
The surgical treatment of cervical spondylosis mainly includes: anterior cervical discectomy and internal fixation, anterolateral cervical surgery or posterior cervical canal enlargement and shaping.