I. What is cervical spondylosis?
Cervical spondylosis is a group of symptoms and signs caused by degenerative changes in the cervical disc tissue and its secondary pathological changes, involving the surrounding tissue structures (nerve roots, spinal cord, vertebral artery, sympathetic nerve, etc.), also known as cervical spine syndrome.
Cervical spondylosis is a common disease among middle-aged and elderly people, and the age of onset is mostly above 40 years old. According to relevant statistics, about 1/4 of people over 50 years old in China have cervical spondylosis; 1/2 of people around 60 years old have cervical spondylosis; almost all elderly people over 70 years old have cervical spondylosis. Long-term clinical observation shows that the age of onset of cervical spondylosis gradually tends to be younger. The occurrence of cervical spondylosis directly affects learning, life and work. How to recognize, treat and prevent cervical spondylosis?
Second, the pathogenic factors of cervical spondylosis
The pathophysiological process of cervical spondylosis is quite complex, and there are various factors in its pathogenesis. However, the following factors play an important role in the generation and recurrence of cervical spondylosis.
1, age factor: just like a machine, with the growth of age, the wear and tear of the human body parts is increasing, the cervical spine will also produce various degenerative changes, and the degenerative changes of the intervertebral disc are the basis for the development of cervical spondylosis.
2, chronic strain injury: refers to a variety of more than the normal range of excessive activities brought about by the injury, especially long-term low head workers cervical spondylosis incidence is particularly high.
3, trauma: on the basis of cervical spine degeneration and instability, trauma to the head and neck is more likely to induce the generation and recurrence of cervical spondylosis.
4.Congenital deformity of cervical spine: such as congenital fusion of vertebrae, skull base depression, cervical rib and spinal stenosis are easy to induce the occurrence of cervical spondylosis.
5, lifestyle changes: modern people have reduced activity, the neck does not often move, so the cartilage without activity will be malnourished, malnutrition will cause degeneration, degeneration, and even fracture and prolapse.
6, pharyngeal inflammation: when there is acute or chronic inflammation in the throat, due to inflammatory edema of the surrounding tissues, it is easy to induce the appearance of cervical spondylosis symptoms or make the condition worse.
7, metabolic factors: due to various reasons caused by human metabolic disorders, especially calcium, phosphorus metabolism and hormone metabolism disorders, often prone to cervical spondylosis.
8, genetic factors: If a person’s cartilage collagen is defective in genetic factors, then it is more fragile and prone to cervical spondylosis.
9, climate factors: local cold not only makes muscle spasm, blood flow stagnation, and can lead to cervical spine internal and external balance imbalance, aggravate the cervical spine instability, inducing disease.
10, mental factors: from clinical practice found that bad mood often aggravate cervical spondylosis, and cervical spondylosis aggravation or attack, the patient’s mood is often worse, easily agitated and tantrums, cervical spondylosis symptoms are also more serious .
Third, the clinical manifestations of cervical spondylosis
The clinical manifestations of cervical spondylosis are complex and varied, and abnormal symptoms may appear from the head, down to the legs and feet, superficial to the skin and deep to the internal organs. Cervical spondylosis is generally divided into five types according to the different symptoms that occur in the different tissues involved.
1, cervical cervical spondylosis: mainly manifested as soreness and discomfort in the neck and shoulders, “back stiffness”, “neck tightness”, easy fatigue in the neck after reading and writing for a long time, sometimes feeling headache, posterior occipital pain, chest pain and upper limb weakness, etc., but no upper limb scurrying pain, The symptoms of acute onset of neck and shoulder pain is severe, the head and neck dare not turn, which is commonly known as “fallen pillow”. Cervical cervical spondylosis is the initial stage of cervical spondylosis, and it is also a favorable time for treatment, if we do not pay attention to prevention and treatment, it may develop into other types of cervical spondylosis.
2.Neurogenic cervical spondylosis: It mainly manifests as pain in the neck and shoulder and overcharge-like pain to one side or bilateral upper limbs, with obvious pain, which affects work and life. This is because the nerve roots are stimulated and compressed by cervical disc herniation and osteophytes, which causes sensory and motor dysfunction of the upper limbs.
3.Vertebral artery type cervical spondylosis: In addition to neck and shoulder pain, patients also have symptoms such as dizziness, vertigo, episodic headache, sudden amblyopia, diplopia, and even nausea and vomiting. If you suddenly feel the sky spinning when you turn your head and the person is shaky and unstable; or if you faint when you turn back suddenly while standing or walking, go to the hospital to check whether it is caused by vertebral artery type cervical spondylosis. The above clinical manifestations will occur when the cervical disc herniation, narrowing of the vertebral space, hyperplasia of the hook vertebral joint and synovial joint compress or stimulate the vertebral artery, causing insufficient blood supply to the brain.
4.Sympathetic cervical spondylosis: this type of cervical spondylosis is the most difficult to diagnose. Its incidence is not high, but the symptoms are colorful and complicated, and the impact is extensive, including the upper trunk, head, upper limbs, internal organs and five senses on the affected side, which involves the area where the sympathetic nerves are distributed, and thus the following symptoms can appear.
◆ Eye symptoms: eye swelling and pain, photophobia and tearing, blurred vision, blurred eyes, flying mosquitoes, etc., or sunken eyes, droopy eyelids, dry eyes, etc..
Nasal symptoms: nasopharyngeal discomfort, pain, nasal congestion, or foreign body sensation, etc.
◆Ear symptoms: tinnitus, hearing loss, even deafness, etc.
◆Throat symptoms: throat discomfort, dryness, foreign body sensation, etc.
◆ Head symptoms: headache, migraine, feeling of heaviness in the head, pain in the occipital region or the back of the neck, and facial fever, redness, numbness, etc.
◆ Symptoms of vasomotor disorders: coldness, cyanosis, numbness, pain, edema, and decreased skin temperature in the limbs, etc.; or redness, burning, pain, and swelling in the limbs, etc.
◆Neurotrophic and sweat gland dysfunction: thinning of the skin, excessive sweating or less sweating, excessive hair, or dryness and loss of hair, etc.
◆Cardiovascular symptoms: panic, chest tightness, arrhythmia, pain in the precordial region, paroxysmal tachycardia, high and low blood pressure, etc.
Other symptoms: nausea and belching, stomach and epigastric discomfort and pain, thin stools or constipation, frequent and urgent urination, incomplete dripping, amenorrhea, etc.; there may also be insomnia and dreaminess, irritability, impulsiveness and other emotional symptoms.
If some of the above symptoms appear and no organic lesion of the corresponding organ can be found, you should be alert to the presence of cervical spondylosis.
5, spinal cord type cervical spondylosis: less common, the patient’s limbs are weak, numb, muscle strength is reduced, walking is unstable, gait is awkward, “as if stepping on cotton”; there is a tight feeling in the chest or waist. As the condition worsens, top-down limb paralysis and loss of control of urination and defecation occur.
Mixed cervical spondylosis: Two or more types of cervical spondylosis symptoms appear at the same time.
The symptoms of cervical spondylosis are complex, so if you have some of the above-mentioned manifestations, you must go to the hospital for examination and treatment and receive preventive rehabilitation guidance from a specialist.
IV. Treatment of cervical spondylosis
Once you are diagnosed with cervical spondylosis, you should first receive treatment under the guidance of a specialist in a regular hospital. Generally speaking, the treatment of cervical spondylosis follows the principle from conservative treatment to minimally invasive interventional treatment to surgery, and the following methods are selected according to different types and conditions.
(I) Conservative treatment
1.General treatment: change the poor posture and position in life and work. In acute attacks, rest on a hard bed, and if necessary, add a neck brace to stop pain and limit head movement. Choose a pillow of appropriate height and firmness. Strengthen the activity exercise of the neck in all directions to enhance muscle strength.
2.Medication: neurotrophic drugs such as vitamin B; non-steroidal anti-inflammatory and analgesic drugs such as fenbid, fotarine, etc.; vasodilators such as compound salvia, etc.; blood-stasis activating, tendon-relieving and meridian-relieving herbal medicines such as blood circulation capsule, cervical rehabilitation, etc.
3, cervical traction therapy: can make the muscles and ligaments relax, widen the vertebral space, blood flow, and can make the nerve roots of adhesion relax. This method is generally not applicable to spinal cord type cervical spondylosis.
4, physiotherapy: physical therapy has the effect of promoting local blood circulation, antispasmodic, anti-inflammatory and anti-swelling. High frequency (microwave, ultra-short wave, etc.), low and medium frequency electrotherapy (TENS, low frequency, interferential electrotherapy, interference electrotherapy, computerized medium frequency, etc.), ultrasound, magnetic therapy, iontophoresis, laser, infrared therapy, etc. can be used.
5, acupuncture, acupuncture therapy is also often used.
6.Massage manipulation therapy: according to the condition and the operator’s experience, it can be used as appropriate.
7.Exercise therapy
8.Psychotherapy
9.Local injection and nerve block therapy: Injecting anti-inflammatory and analgesic drugs into local pain points or epidural cavity can block the vicious cycle of pain, release muscle spasm, eliminate edema and promote the absorption of sterile inflammation.
(II) Minimally invasive interventional treatment
Generally after three months of systematic conservative treatment if it is ineffective, minimally invasive interventional therapies are available for most patients. These therapies include.
1, percutaneous collagenase intervertebral disc chemolysis.
2, percutaneous ozone disc myelolysis.
3, percutaneous radiofrequency disc nucleus pulposus coagulation and contraction decompression
4, percutaneous laser disc decompression (PLDD).
(iii) Surgical treatment
Surgical treatment is to be considered if one of the following conditions exists.
1.Patients with cervical spondylosis who have been ineffective with systematic conservative treatment and minimally invasive treatment
2.Progressive aggravation of nerve root or spinal cord compression symptoms or recurrent attacks that affect work or life. Imaging examination confirms that bony stenosis or osteophytes of the spinal canal predominate.
3.Spinal cord type cervical spondylosis with gradually increasing symptoms.
V. Preventive care of cervical spondylosis
Cervical spondylosis is a chronic degenerative disease, which has undergone a long development process. So usually pay attention to prevention, avoid some factors that cause cervical degeneration in daily work and life, and eliminate the triggering factors of cervical spondylosis.
1 .Prevent trauma: avoid carrying heavy objects on the head and neck, do not doze off when riding in a car (to prevent “whip injury” caused by emergency braking); prevent flash contusion when working or walking.
2, the correct sleeping position, the pillow is appropriate: generally supine, side lying is appropriate, the pillow can not be too high or too low, the height of the pillow after pressure is the size of a standing fist. For those who are used to lying on their side, the pillow height is appropriate from the midpoint of the spinous process to the distance of the lateral edge of the shoulder peak. The neck should be pillowed on the pillow, can not be suspended, so that the head to keep slightly back.
3, correct bad posture and habits: avoid prolonged low head ambulation work, appropriate control of watching TV and chess entertainment time to reduce cervical fatigue and induce cervical spondylosis. No matter what the situation is, keep the cervical spine easy and comfortable, avoid leaning the body forward for a long time. Read a book, TV, computer 1 hour, you should get up and move around, do a cervical spine protection exercise.
4, to prevent the neck from cold: the neck should be warm in winter, the use of air conditioners and electric fans in summer should be moderate.
5.Treatment of pharyngitis: when the throat is inflamed bacteria, viruses, etc. can spread retrogradely through the lymph nodes to the area around the circumoccipital joint where the lymph nodes behind the throat are gathered, resulting in a decrease in muscle strength and displacement of the vertebral body due to imbalance between internal and external balance, causing cervical spondylosis.
6, strengthen exercise, self-care: adhere to physical exercise, enhance physical fitness, delay the degenerative changes of bone and ligament. If you have the conditions, you can choose to fly kites, swimming and cervical spine exercises, etc.
7, maintain a good state of mind, avoid mental tension.
Cervical spondylosis does not appear overnight, its occurrence is a gradual process, closely related to our daily life and work habits. “Seven points of maintenance, three points of treatment”, so the prevention of cervical spondylosis should be done from the usual little by little. If the symptoms of cervical spondylosis appear to go to the hospital in time to avoid aggravation of the disease and more difficult treatment.
Remember: early treatment + good habits + active exercise = health.