Cervical spondylosis is a series of symptoms (such as neck, shoulder and arm pain, numbness, vertigo, etc.) and signs caused by degenerative changes in the cervical intervertebral disc and its corresponding intervertebral joints, resulting in involvement of the adjacent tissues, such as the spinal cord, nerve roots, vertebral artery or sympathetic nerves. These are collectively referred to as cervical spondylosis. There are many types of cervical spondylosis, which are clinically divided into local, nerve root, spinal cord, vertebral artery, sympathetic nerve, mixed and esophageal compression types.
I. Subtypes.
(A) Cervical type.
(1) Abnormal sensations such as head, neck and shoulder pain, with corresponding pressure points.
(2) The cervical spine shows curvature change or intervertebral joint instability on X-ray.
(③ Other disorders of the neck should be excluded (drop pillow, frozen shoulder, rheumatic myofibrositis, neurasthenia and other shoulder and neck pain not caused by degenerative disc degeneration).
(ii) Nerve root type.
① With more typical radicular symptoms (numbness and pain) and the scope is consistent with the area innervated by the cervical spinal nerve.
(ii) Positive head press test or brachial plexus pull test.
③The imaging findings are consistent with the clinical presentation.
④No significant effect of painful point closure (this test may not be performed if the diagnosis is clear).
(⑤Excluding the disorders caused by extra-cervical spine lesions (thoracic outlet syndrome, tennis elbow, carpal tunnel syndrome, elbow tunnel syndrome, frozen shoulder, biceps tenosynovitis, etc.) with upper limb pain as the main cause.
(iii) Spinal cord type.
(i) Clinical manifestations of strong damage to the cervical spine.
(ii) Radiographs show osteophytes and spinal stenosis at the posterior edge of the vertebral body. The presence of spinal cord compression is confirmed by imaging.
(③Excluding amyotrophic spinal cord sclerosis, spinal cord tumor, spinal cord injury, secondary adhesive arachnoiditis, and multiple peripheral neuritis.
(iv) Vertebral artery type.
(1) There have been sudden collapse episodes. With cervical vertigo.
(ii) Positive rotational neck test.
(iii) X-ray shows segmental instability or osteophytes of the cardinal joints.
④More often accompanied by sympathetic symptoms.
⑤Except ophthalmogenic and otogenic vertigo.
(6) Exclude insufficiency of basilar artery supply caused by compression of vertebral artery segment I (the segment of vertebral artery before entering the transverse foramen of cervical 6) and vertebral artery segment III (the segment of vertebral artery before exiting the cervical spine into the skull).
(vii) Vertebral arteriogram or digital subtraction vertebral arteriogram (DSA) is required before surgery.
(v) Sympathetic nerve type.
Clinical manifestations include a series of sympathetic symptoms such as dizziness, dizziness, tinnitus, hand numbness, tachycardia, precordial pain, etc. There is instability or degeneration on x-ray. Negative vertebral arteriogram.
Second, conservative treatment.
1, traction (preferred treatment for nerve root type, cervical type and sympathetic cervical spondylosis).
2.Tui na in Chinese medicine.
3.Physiotherapy.
4, nerve block therapy.
5, medication (Chinese herbal tonics for diagnosis and treatment + Western medicine for symptomatic treatment).
6.Chinese herbal medicine foot soak.
7. guidance on activities of daily living.
Third, surgical treatment (spinal cord type conservative treatment is ineffective)
1. posterior cervical decompression of the lateral block plate fixation.
2.Anterior cervical decompression, plate and titanium mesh internal fixation.
Prevention of cervical spondylosis
1, strengthen the neck and shoulder muscle exercise, do head and double upper limbs of forward flexion, backward extension and rotation movement, not only can relieve fatigue, but also can make the muscle developed, toughness enhanced, thus conducive to the stability of the cervical segment of the spine, enhance the ability of the neck and shoulder to comply with sudden changes in the neck.
2, remove the habit of high pillow sleep. High pillows make the head bend forward, increasing the stress on the lower cervical spine, which can accelerate cervical degeneration.
3, pay attention to the neck and shoulder to keep warm, avoid head and neck weight, avoid excessive fatigue, do not doze off when sitting in a car.
4, early and thorough treatment of neck and shoulder, back soft tissue strain to prevent its development into cervical spondylosis.
5, labor or walking to prevent the cervical spine flash, contusion.
6.Long-term ambulatory workers should change their head position regularly and do neck and shoulder muscle exercise on time.
7, pay attention to the correct posture of the head, neck, shoulders and back, do not deviate from the head, shrugging shoulders, talking, reading books to look at the front to keep the spine straight.