I. The main clinical manifestations of cervical spondylosis
Cervical spondylosis is a common and multi-infarct disease, which is more common in adults between 40 and 60 years old, with more men than women. The lesions mainly involve the cervical intervertebral discs and surrounding fibrous structures, accompanied by obvious degeneration of cervical nerve roots and spinal cord. The main clinical symptoms of the disease include pain in the head, neck, arm, hand and forehead, and there may be progressive limb sensory and motor disorders, and in severe cases, it may lead to limb weakness, even incontinence and paralysis.
II. Types of cervical spondylosis
The clinical manifestations of cervical spondylosis vary according to the location of the lesion, the tissue under pressure and the severity of the compression. Some of its symptoms can be alleviated or relieved by themselves, or recurrent; individual cases have stubborn symptoms, affecting life and work. According to the clinical symptoms, it is roughly divided into nerve root type, spinal cord type, vertebral artery type and sympathetic nerve type. However, various mixed types with mixed symptoms and signs between each type can be seen in clinical practice.
Clinical symptoms of neurogenic cervical spondylosis
It is mostly seen in people over 40 years old, with a slow onset and no history of trauma. However, the disease can be triggered when the head is traumatized for various reasons.
The main symptoms include neck, shoulder and back pain and cervical nerve irritation or compression.
The important signs are.
(a) Different degrees of deformity and stiffness in the neck.
(ii) Pressure points are below the cervical transverse process of the involved cervical spinal nerve and the area innervated by its dorsal branch.
(C) Positive brachial plexus nerve pull test.
(iv) Positive intervertebral foraminal compression test.
(v) Positive subacromial compression test.
(vi) When the cervical nerve is irritated, its distal part shows painful hypersensitivity in the early stage; when it is compressed more heavily or for a longer period of time, its distal part shows hyposensitivity.
(vii) When the main nerves innervating the biceps and triceps tendons are excited, the tendon reflexes are active, and conversely, the tendon reflexes are diminished or absent.
(H) When the nerve roots are compressed, the strength of the muscles they innervate is reduced in the mild cases, and muscle atrophy can be seen in the severe cases.
Clinical signs of spinal cord cervical spondylosis
Clinically, according to whether the compression is located in the center of the spinal cord or on one side, it can be divided into simple spinal cord type and mixed spinal nerve root type.
The clinical symptoms are
(a) Upper extremity symptoms: simple motor disorder, simple sensory disorder or both sensory and motor disorder in one or both upper extremities.
(ii) Lower extremity symptoms: neurological dysfunction appearing in one or both lower extremities.
(iii) Lateral symptoms: sensory-motor disorders appearing in the ipsilateral upper and lower extremities.
(iv) Crossed symptoms: sensory or motor disorders appearing in one upper extremity and the contralateral lower extremity.
(v) Extremity symptoms: neurological dysfunction in the extremities.
(vi) Head symptoms: mainly manifested as headache, dizziness or scalp pain.
(vii) Sacral nerve symptoms: manifested as urination or defecation disorders.
V. Clinical signs of vertebral artery type cervical spondylosis
(I) Typical symptoms of vertebral artery insufficiency of blood supply: episodic vertigo, diplopia with nystagmus, sometimes nausea, vomiting, and even tinnitus and deafness.
(ii) Sudden collapse.
(iii) Brainstem symptoms: numbness and abnormal sensation in the limbs, falling to the ground with objects. (iv)Occipital throbbing pain.
(V) Episodic coma.
VI. Clinical signs of sympathetic cervical spondylosis
(I) Sympathetic excitation symptoms.
1. Headache or migraine, dull head, dizziness, occipital pain or posterior neck pain.
2. Enlarged eye fissures, blurred vision, dilated pupils, painful eye sockets, dry eyes and eyes, and gold stars in the visual field, etc.
3. Rapid heartbeat, heart rhythm disturbance, precordial pain and elevated blood pressure, etc.
4.The limbs are afraid of cold and cold, the local temperature is low, or the limbs have a tingling sensation when they are cold, followed by redness and swelling or pain aggravation.
5.Disorder of sweating.
(ii) Sympathetic inhibition symptoms.
There are dizziness, drooping eyelids, lacrimation, nasal congestion, bradycardia, low blood pressure, increased gastrointestinal motility or warmth, etc.