What is cervical spondylosis?
Cervical spondylosis is a common and prevalent disease that accompanies efficient life in modern society, with an incidence rate of about 15%. Cervical spondylosis refers to the clinical symptoms and signs of cervical spondylosis. The current international consensus is that cervical spondylosis refers to the corresponding symptoms and signs caused by degenerative degeneration of the cervical disc and its secondary degenerative degeneration of the intervertebral joints and ligaments, resulting in damage to the spinal cord, nerves and blood vessels.
There are various symptoms of cervical spondylosis, specifically, the following: stiffness, stiffness and pain in the neck, restricted neck movement, heavy shoulders and back, hardening of muscles; weakness in the upper limbs, numbness in the fingers, reduced sensation in the skin of the limbs, and sometimes unconscious falling of objects held in the hands; some patients will also experience disobedience of the lower limbs and a feeling of stepping on cotton; some patients have abnormal sensations such as headache, dizziness, loss of vision, tinnitus and nausea Some patients have abnormal sensations such as headache, dizziness, loss of vision, tinnitus, nausea, etc.; a few severe cases may experience loss of control of urination and defecation and even tetraplegia. Not all the manifestations are manifested in every patient, but often only some of the symptoms appear, and most patients have mild manifestations and a long course of illness.
Why do I get cervical spondylosis?
The pathophysiological process of cervical spondylosis is quite complex. There are various factors that contribute to its development. However, the following factors play an important role in the development and recurrence of cervical spondylosis.
(1) Age factor: just like a machine, the wear and tear of the human body parts increases with age, and the cervical spine also produces various degenerative changes, and degenerative changes of the intervertebral disc are the most basic and critical basis for the development of cervical spondylosis. In addition, degeneration of small joints and various ligaments also play an important role.
(2) Chronic strain injury: It refers to the injury brought about by various excessive activities beyond the normal range, such as bad sleep, improper height of the pillow or improperly padded parts, and the higher prevalence of repeatedly dropped pillow. In addition, improper work posture, especially the incidence of cervical spondylosis is particularly high in long-term low-headed workers. In addition, some inappropriate physical exercise will also increase the incidence, such as the inappropriate inversion, somersault, etc.
(3) Trauma: On the basis of cervical spine degeneration and instability, trauma to the head and neck is more likely to induce the production and recurrence of cervical spondylosis. Patients often have sudden onset of symptoms after minor trauma, and the symptoms are often severe, and the combination of fracture and dislocation adds to the difficulty of treatment.
(4) Developmental spinal stenosis: people with spinal stenosis are more likely to develop cervical spondylosis, and the prognosis is relatively poor.
(5) Congenital malformations of the cervical spine: various congenital malformations, such as congenital vertebral fusion and skull base depression, can easily induce the occurrence of cervical spondylosis.
(6) Metabolic and rheumatic disease factors: human metabolic disorders caused by various reasons, especially calcium, phosphorus metabolism and hormone metabolism disorders, in addition to rheumatoid arthritis and ankylosing spondylitis are also prone to accompany the generation of cervical spondylosis.
What are the subtypes of cervical spondylosis?
The disease can be broadly divided into six types: cervical, radicular, spinal, vertebral artery, sympathetic and mixed.
Cervical type: It is caused by long-term single posture of the head and neck, resulting in strain on the neck muscles, ligaments and joints. Patients mainly show symptoms such as easy fatigue of the neck, neck straightness and pain, inability to read and write for a long time, and often feeling tightness and stiffness of the neck and inflexibility of movement in the morning.
Nerve root type: It is the most common type of cervical spondylosis, accounting for about 60% of the cases. Neurogenic cervical spondylosis is a disease caused by cervical spine degeneration and hyperplasia, which stimulates and compresses the cervical nerve roots. Patients often feel pain and numbness in the head, neck, shoulders, arms and hands, and the numbness mostly occurs in the fingers and forearms.
Spinal cord type: It is a more serious cervical spondylosis, which is caused by the direct compression of the cervical spinal cord due to the backward protrusion of the cervical intervertebral disc and the osteophytes of the vertebrae. When the spinal cord is compressed, patients may experience unilateral or bilateral numbness, soreness and weakness in the upper or lower limbs, and in severe cases, symptoms such as difficulty moving and unstable walking may occur.
Vertebral artery type: It is also a common type of cervical spondylosis, which is based on the degeneration of the cervical spine and causes a series of diseases due to insufficient blood supply to the vertebral artery. At the onset of the disease, patients have varying degrees of vertigo, which is also accompanied by nausea, vomiting, diplopia, tinnitus, deafness and other symptoms. Vertigo occurs whenever the patient tilts his head back, lowers his head to read a book, turns his head suddenly, or repeatedly turns his head from side to side. Sudden collapse is a unique symptom of this disease. Often, when the neck is turned, numbness and weakness of the limbs suddenly occur and the patient falls, but the patient is clear and can mostly get up by himself.
Sympathetic nerve type: This type of cervical spondylosis is mainly caused by degenerative degeneration of the cervical spine and stimulation or compression of the sympathetic nerve in the neck by osteophytes. As the sympathetic nerve is stimulated, it causes dysfunction of the internal organs, glands and blood vessels it innervates. Patients mainly show symptoms such as self-induced head and occipital pain, dizziness, migraine, panic, chest tightness, cold limbs, and low skin temperature.
Mixed type: Patients who have more than two of the above symptoms are collectively called mixed cervical spondylosis .
How to self-check for cervical spondylosis
In the past 3 months, have you had the following symptoms repeatedly?
1.Long-standing headache or dizziness.
2. pain or soreness in the neck and shoulders
3.Unexplained arrhythmia, angina-like symptoms.
4, untreated hypotension or hypertension.
5. unexplained acid reflux, eructation, nausea and vomiting.
6. numbness and weakness of the extremities, or strange sensations such as pins and needles, burning sensation, cold sensation, itchy sensation like ants crawling through or diminished sensation as if wearing gloves.
7.Movements such as buttoning, tying shoelaces, pinching pens and writing are not well coordinated
8.Sudden numbness of the whole body when lowering the head, or an electric-like sensation
9, unexplained repeated “pillow”.
If you have any two of the above nine, you have to consider whether you have the possibility of cervical spondylosis. It is recommended to come to the clinic for further examination.
How to prevent cervical spondylosis
I. Adjust your posture
Correct standing, walking and sitting postures are important for the prevention of cervical spondylosis, lumbar spondylosis and other bone and joint diseases.
Adjust your standing posture
The correct standing posture should be: standing with the whole body slightly up from the center of the feet, i.e., abdomen and chest; shoulders open and slightly backward; hands slightly closed and naturally drooping; jaw slightly tightened, gaze level, the top of the head such as a bowl of water or a book; back waist tightened, pelvis up, leg muscles taut, knees inside clenching, so that the spine to maintain the normal physiological curve.
From the side, the ears, shoulders, hips, knees and ankles should be in a vertical line. With the adjustment of breathing, should find a slightly tense in the relaxation of the confident, comfortable feeling. The correct standing posture can be trained from the back against the wall, once a day in the morning and once in the evening, for 15 minutes each time, with a book on your head.
Walk every step well
The correct walking posture should be carried out on the basis of correct standing posture. Hands slightly thrown behind you. Clench your legs and try to walk in a straight line with both feet. Walk with your heels on the ground first and your feet on the ground afterwards, and produce a rhythmic slight twist in your hips.
Correct sitting posture
The correct sitting posture is actually an extension of the correct standing and walking posture, and should be as close as possible to the distance from the workbench, the height of the table and chairs to the best state with their height ratio. People who often use the computer to raise the position of the computer monitor a few centimeters, or to the computer monitor pad a few thick books, the line of sight and the screen to the level. This changes the previous head-down action to head-up, preventing cervical spondylosis at the source. At the same time, do not keep a sitting posture for a long time, stand up and move more, turn your head.
Waist straight, shoulders still back, work intervals should often do with breathing natural shoulder lifting action, every 5-10 minutes should be raised back to rest for a moment, so that the head, neck, shoulders, chest in a slightly tense normal physiological curve state, and try to avoid excessive head and neck leaning forward or backward.
The hips should be in full contact with the chair surface, can often use the back of the chair to hold the back of the waist for a short rest. Special reminder of the head left or right writing habits of white-collar workers should pay attention to correct “bias”, such as a moment to change, can slowly turn the head every hour for a moment to eliminate the “bias neck” state of muscle fatigue.
Second, choose a suitable pillow
The height is appropriate. The appropriate height of the pillow, to 9-10 cm more appropriate, the specific size of each person’s physiological characteristics, especially the physiological curvature of the neck. Shoulder wide body fat pillow can be slightly higher, thin people can be slightly lower. People who are used to sleeping on their backs, the pillow height should be compressed and their fist height (fist up the height of the fist high standard) is appropriate; people who are used to sleeping on their sides, the pillow height should be compressed and their side of the shoulder width height is appropriate. Of course, regardless of supine sleep, side sleep can maintain the normal physiological curvature of the neck cervical spine pillow is the most ideal.
Soft and hard moderate. Cervical spondylosis pillow should choose a slightly softer, but not lose a certain type of hardness, on the one hand, can reduce the pressure between the cervical spondylosis pillow and the scalp, on the other hand, and maintain the uneven pressure, so that the blood can pass from the pressure is less. Cervical spondylosis pillow as long as slightly elastic can be, elastic too big will cause neck muscle fatigue and injury.
Three, teach you simple neck care
1, head hand confrontation training The main practice is: the hands crossed fingers on the neck, head force backward, hand force block, confrontation force, although the head did not move, but through the two directional force contest let the corresponding neck muscles contraction; the same, we can use the hand against the left side of the head, the head to the left, hand and head resistance, the right side of the same. You can also rotate the neck left and right, and rub the neck muscles with your hands, this exercise can relax the tense muscles in the neck, which has a very good protective effect on the neck.
2, simple neck health exercises.
The first type: front and back. Before doing the exercise, natural standing, feet and shoulder width, the following assortment with. Action, hands crossed waist, first lift the head back, while inhaling, eyes looking at the sky, stay for a moment; then slowly to the front of the chest part of the head down, while exhaling, eyes looking at the ground. Repeat up and down four times.
The second form: raise the arm and turn around. Raise the right arm first, palm down, look up at the palm of the hand, slowly turn the body to the left side, stay for a moment and then turn to the right rear side. Note that the heel turns 45 degrees, the body weight leans forward, and when turning the neck and waist, try to turn until you can’t. Stay for a moment, return to the natural pose and then switch to the left arm.
The third pose: left and right rotation. First turn your head slowly to the left side, while inhaling in your chest, let the right side of your neck straighten, stay for a moment, then slowly turn to the left side, while exhaling, let the left side of your neck straighten, stay for a moment. Repeat four times alternately.
Type 4: Lift shoulders and neck. Slowly lift both shoulders and shrink the neck as far down as possible, stay for a moment, then slowly restore the natural; then sink both shoulders and stretch the head and neck upward, stay for a moment, relax both shoulders and exhale naturally. Repeat four times.
The fifth form: swing from side to side. Cross your arms and tilt your head slowly to the left so that your left ear is pressed against your left shoulder, stay for a moment and then return your head to the middle position; then change to the right side. Repeat four times.
The sixth form: wave flexion and extension. Lower jaw to the lower front wave flexion and extension, pay attention to the lower jaw as close as possible to the front chest, shoulders carry; lower jaw slowly flexed, chest forward, shoulders back up and down slowly movement. Then do it backwards, and practice it twice forwards and backwards.
Four, sports prevention: breaststroke
Breaststroke in the exchange of breath when the neck from parallel to the surface of the water backward upward, the head exposed to the surface of the water to breathe, the head and neck is always in a low, a state of back, just in line with the principle of cervical spondylosis exercise, so it can play a positive role in the prevention and treatment of cervical spondylosis. The principle of action when playing badminton catching high ball is roughly the same as breaststroke. Breaststroke swimming and playing badminton to prevent cervical spondylosis should be different from time to time and from person to person, serious cervical spondylosis patients can not swim exercise.
What is good for the body to eat for cervical spondylosis?
The general dietary principles of cervical spondylosis patients are: reasonable with, diet should be reasonable with, not a single partial diet.
Cervical spondylosis food is generally divided into two categories: one is the main food, mainly to provide heat, such as rice and noodles, are in this category; the other food, which can regulate physiological functions, is called a side food, such as beans, fruits and vegetables. The nutrition contained in the main food is different, coarse and fine to eat at the same time, not a single partial food. Coarse and fine, dry and sparse, main and secondary with a comprehensive nutrition can meet the needs of the body, promote the recovery of patients and maintain the needs of the normal body.
As cervical spondylosis is caused by vertebral hyperplasia, bone degeneration and osteoporosis, so patients with cervical spondylosis should eat a diet rich in calcium, protein, vitamin B, vitamin C and vitamin E. Calcium is the main component of bone. Calcium is the main component of bone, with milk, fish, pig tail bones, soybeans, black beans and other content as much. Protein is also an indispensable nutrient for the formation of ligaments, bones and muscles. Vitamins B and E, on the other hand, can relieve pain. Relieve fatigue.
Those with blurred vision and lacrimation are advised to eat more foods containing calcium, selenium and zinc. Such as soy products, animal liver, eggs and fish, mushrooms, asparagus, carrots, cervical spondylosis with hypertension, eat more fresh vegetables and fruits, such as bean sprouts, kelp, fungus, garlic, celery, groundnuts, winter squash, green beans.
Cervical spondylosis is best not to eat food: 1, should quit smoking, alcohol. 2, do not often eat cold and overheated food. 3, avoid greasy and thick-flavored products.
4, avoid spicy and stimulating food.
Treatment of cervical spondylosis
The treatment methods for cervical spondylosis can be divided into two categories: non-surgical treatment and surgical treatment. Non-surgical treatment mainly includes: 1) medication 2) traction therapy 3) physiotherapy 4) cervical brace fixation protection
Drug treatment
1.Non-steroidal anti-inflammatory and analgesic drugs. This class of drugs is mainly for the nerve root stimulation caused by the damage of inflammation, to play the role of anti-inflammatory analgesia. The main drugs are: mobicol, celebrex, futalin, etc. The use of this class of drugs requires attention to the presence of gastrointestinal diseases.
2.Muscle relaxation drugs. This type of drug makes the muscle spasm relieved, relieving the stimulation of the spinal cord, nerves and blood vessels. Myna as a representative of muscle relaxation drugs.
3.Sedatives. Sedatives can reduce the excitability of nerves, but also to relieve muscle tension, suitable for mental excitement, tension, agitation of the patient. Generally used Valium or alprazolam, taken orally at bedtime, but also available brain and tranquilizing Chinese medicine.
4, neurotrophic drugs. This is a drug that has therapeutic significance for any type of cervical spondylosis. Common drugs include vitamin B1 tablets, and neurotropic is also an effective neurotropic drug with pain-relieving effect.
5. Anti-dizziness medication Patients who have dizziness symptoms can take medications that improve the amount of blood in the brain and in the ear represented by Min Make Long.
Traction therapy
Cervical traction therapy is a more effective and widely used treatment for cervical spondylosis. It is suitable for all types of cervical spondylosis and is more effective for early cases. Cervical traction for spinal cord type cervical spondylosis of long duration can sometimes aggravate the symptoms, so it is less commonly used.
Traction weight is 2-6kg, 1-2 times a day for 1 hour each time, 10 days as a course of treatment. Can also continue to traction, 6-8 hours a day, 2 weeks for a course of treatment. If the symptoms are aggravated after traction, it is not advisable to traction again, and you should go to hospital for regular treatment.
Physiotherapy
The main function of physiotherapy is to relax the muscles and reduce pain.
Neck brace protection
The role of cervical brace is to stabilize the cervical spine and limit its mobility, which is especially suitable for people with cervical instability and long-term head-down work.
However, the long-term application of cervical brace and collar can cause muscle atrophy and joint stiffness in the back of the neck, which is not beneficial instead, so the wearing time should not be too long, and medical physical exercise should be carried out frequently during the application. After the symptoms are gradually reduced, the collar and neck brace should be removed in time to strengthen the muscles.
Surgical treatment methods
Patients with the following conditions require surgical treatment and are recommended to be seen by a specialist outpatient.
1) Increased numbness in the hands and feet.
2) Increased vertigo.
3） Weakness in walking and a feeling of stepping on cotton.
4） Restriction of limb movement, especially basic movements such as buttoning and tying shoelaces.
5） Imaging confirms the presence of cervical instability and spinal stenosis.
6） Trauma causing cervical spine fracture and cervical spine dislocation.
Cervical disc nucleus pulposus ablation
Cervical disc nucleus pulposus ablation is a minimally invasive, percutaneous procedure that is particularly suitable for patients with cervical vertigo. The advantage of this procedure is that it is minimally invasive, with essentially no incisions and a short operative time, and ablates the water in the nucleus pulposus of the disc with low-temperature plasma energy to achieve a reduction in intravertebral disc pressure.
Anterior cervical interbody fusion fixation
For spinal cord cervical spondylosis, anterior cervical interbody fusion is performed with a small incision to remove the patient’s severed disc and fix it with a bone graft. The advantages of this procedure are complete decompression, good recovery of neurological function, and the ability to walk on the floor 3 to 5 days after surgery.
Cervical spine artificial disc replacement
Cervical artificial disc replacement is a new technique that has emerged in recent years, in which an artificial cervical disc is used to replace the existing degenerated or ruptured disc. The advantage of this procedure is that it is minimally invasive, highly bionic, and preserves the mobility of the original segment to the greatest extent possible. There is no increased stress on the upper and lower cervical joints.
Cervical discoscopic nucleus pulposus removal
Cervical discoscopy is a micro-innovation technology unique to our department, and at present, this procedure is only carried out in internationally renowned hospitals and several large domestic orthopedic hospitals. It is suitable for nerve root type cervical spondylosis. The advantage is that it can thoroughly perform decompression of the nerve root canal, and it is less invasive and does not affect the mobility of the intervertebral joints.
What things need attention after surgery?
1.After cervical spine surgery, especially after intervertebral fusion, it is necessary to wear a cervical brace for at least 1 month.
2.Patients need to go to the outpatient clinic for follow-up, especially for intervertebral fusion surgery and cervical disc replacement surgery.
3.Patients need to pay attention to the protection of cervical spine after surgery and reduce the neck load and strenuous activities.
4.Patients with limb dysfunction need to continue rehabilitation training.