I. Common types of cervical spondylosis
The cervical spine is located between the head, chest and upper limbs, and is the smallest of the spinal vertebrae, but the most flexible, most frequently active and heavily loaded segment. After about 30 years of age, the cervical intervertebral discs begin to degenerate gradually, the water content decreases and becomes more pronounced with age, and induces or promotes degenerative osteophytes in other parts of the cervical spine, or disc prolapse and ligament thickening, resulting in pressure on the cervical spinal cord, nerve roots or vertebral artery, and a series of clinical symptoms. Therefore, cervical spondylosis is a common and frequent disease among middle-aged and elderly people. Chen Zan, Department of Neurosurgery, Xuanwu Hospital, Capital Medical University
Symptom typing: The symptoms of cervical spondylosis are very rich, diverse and complex, and most patients have mild symptoms at the beginning, which gradually worsen in the future, while there are some patients with severe symptoms. This is related to the type of cervical spondylosis suffered, and the common types are mainly nerve root type, spinal cord type and vertebral artery type cervical spondylosis.
1.Nerve root type
If the nerve root is compressed by the cervical spine’s enlarged bone flab or herniated disc, the patient will experience radioactive pain or numbness in the upper limbs, and the pain and numbness will radiate along the direction of the compressed nerve root and the innervation area, and the patient may experience upper limb weakness or even muscle atrophy in severe cases.
2.Vertebral artery type
In cervical spine hyperplasia, the compression of the vertebral artery by the hook vertebral joint causes episodes of vertigo and diplopia with nystagmus. Sometimes it is accompanied by nausea, vomiting, tinnitus or hearing loss, sudden weakness of lower limbs and sudden collapse. These symptoms are often related to the change in the position of the neck
3.Spinal cord type
The protruding discs or hyperplastic bones of the cervical spine compress the spinal cord, and the patient develops numbness and heaviness in the lower limbs, difficulty in walking, and a feeling of stepping on cotton in both feet; numbness and pain in the upper limbs, weakness and inflexibility in both hands, difficulty in completing fine movements such as writing, fastening, holding chopsticks, and holding objects that fall easily.
II. Minimally invasive neurosurgical techniques for cervical spondylosis
On the basis of traditional cervical spine surgery, Xuanwu Hospital Neurosurgery Spine Microinvasive Treatment Center introduces international advanced microinvasive technology and applies micro neurosurgery technology to the treatment of cervical spine disease, carrying out anterior hook spondylodesis for vertebral artery type cervical spine disease and anterior and posterior nerve root foramen enlargement and shaping for nerve root type cervical spine disease. The surgery is less traumatic and more effective, avoiding the destruction of the stability of the cervical spine by traditional surgery, eliminating the need for internal fixation of the cervical spine and reducing the treatment cost of patients. The use of cervical disc replacement maintains the mobility of the cervical joints and avoids degeneration of the adjacent cervical segments.
The application of a neurosurgical microscope during surgery greatly improves the efficacy and safety of cervical spine surgery.
1. Anterior cervical foramen lock technique for removal of the hook vertebral joint: treatment of nerve root type and vertebral artery type cervical spondylosis
The hyperplasia of the hook vertebral joint on one side of the patient compresses the patient’s vertebral artery, resulting in symptoms such as episodic dizziness and sudden weakness of the lower limbs. The anterior microscopic minimally invasive technique was used to remove the patient’s hook vertebral joint and release the compression on the vertebral artery, and the operation did not affect the stability of the cervical spine, so there was no need for internal fixation of the plate.
2.Posterior cervical locked-hole technique nerve root foramen decompression: treatment of nerve root type cervical spondylosis
In patients with cervical disc herniation and neurogenic cervical spondylosis, the cervical disc is removed using the posterior cervical locking hole technique, and the stability of the cervical spine is maintained, avoiding cervical fusion and plate fixation
3.Artificial disc replacement surgery
In patients with single-segment cervical disc herniation, after adopting artificial cervical disc replacement, the patient’s cervical spine can still be moved normally and degeneration of adjacent segments of the cervical spine can be avoided.