Cervical spondylosis is a syndrome caused by cervical disc degeneration and cervical spine osteophytes, with neck and shoulder pain radiating to the head and occipital region or upper limbs, and in severe cases, spasms in both lower limbs, difficulty walking, and even tetraplegia as the main manifestation. The onset of cervical spondylosis is insidious, and research on the treatment of cervical spondylosis is being conducted in different experiments in China and even in the world, and there are numerous treatment methods. According to medical reports, the treatment methods for cervical spondylosis in China mainly include medication, conservative treatment (acupuncture, massage, massage, traction, etc.), surgical treatment and minimally invasive interventional treatment, in addition to exercise therapy and diet therapy will also have a certain auxiliary effect on the rehabilitation of cervical spondylosis.
The pathogenesis of cervical spondylosis
Cervical spondylosis is mainly based on degenerative changes of the cervical spine, causing cervical disc herniation, cervical spine hook vertebral joint instability, hook vertebral osteophytes and other causes, resulting in obstruction of cervical vertebral artery blood flow. Clinical reports show that most patients with cervical spondylosis have problems with altered cervical curvature, so cervical spondylosis treatment must consider the issue of restoring the physiological curvature of the cervical spine.
In addition, cervical spondylosis in life is caused by poor posture, body position, recurrent inflammation of the throat, strain, head and neck sprains and other external factors that are not reasonably handled and treated, or are not completely improved or lifted after treatment, which can also lead to relapse. Therefore, regular treatment is important, and daily protection is also important, such as choosing a suitable pillow.
Minimally invasive technology treatment
The progress of medicine is always closely related to the progress of science and technology. The recent industrial civilization has bred aseptic surgery, antibiotics, imaging technology, laser technology, computer intelligence technology, nano-materials and other high-tech technologies, which paved the way for the rapid development of modern minimally invasive orthopaedic surgery (MIOS), and the new trend of surgical development in the 21st century is minimally invasive, intelligent, microscopic and Minimally invasive is the inevitable development of surgery, and it is the ultimate goal of surgeons to achieve the best surgical efficacy with the least invasion and physiological interference, which is the concrete embodiment of the diagnosis and treatment concept of “everything for the patient”.
Minimally invasive orthopedics is not defined by incision size alone. Surgeons must first complete adequate and precise surgical operations, and then consider how to improve surgical access and surgical instruments to reduce tissue damage, blood loss, hospitalization time and speed up the recovery process. The “German OM visual minimally invasive lysis” is a revolutionary change in minimally invasive technology.
Minimally invasive technology applied to the treatment of cervical spondylosis is an inevitable change in the development of orthopedics, and it is the most ideal choice for the treatment of cervical spondylosis because it is less invasive, quicker recovery and safer, which is respected by major hospitals and patients.
Drug treatment
Both traditional Chinese medicine and western medicine can play an auxiliary role in the treatment of cervical spondylosis, which can have the effect of anti-inflammation and analgesia.
Western medicine can play an auxiliary symptomatic role in the treatment of this disease, and hospital medication can be used: vasodilators and Chinese herbs, etc., which have a certain effect on the relief of symptoms. Chinese medicine focuses on conditioning, and although it can regulate and delay the onset of cervical spondylosis, it is difficult to achieve a complete cure, and the cycle is long and the side effects are large, such as damage to the liver, kidneys and gastrointestinal tract. Conservative treatment
The common conservative treatment methods for cervical spondylosis are: acupuncture, massage, tui-na, traction, etc. The characteristics of conservative treatment are non-invasive and less costly; however, it is not suitable for all patients with cervical spondylosis.
Acupuncture for cervical spondylosis
It is mainly through acupuncture of different groups of cervical acupoints for patients with cervical spondylosis; the meridian acupuncture group takes the dazhi, fengchi and tianzhu, and the pinch spine group takes the corresponding pinch spine acupuncture point to effectively improve the strength of blood supply to the vertebral artery in a two-way regulation, thus reducing the symptomatic effect of cervical spondylosis. In the experimental studies of acupuncture for cervical spondylosis, there is little research on the efficacy mechanism of acupuncture for cervical spondylosis in general, and if there is a small amount of data on the efficacy mechanism, it is limited to the effect of acupuncture for vertebral artery cervical spondylosis on blood rheology and local blood circulation. There are even fewer experimental studies to explore the mechanism of acupuncture for cervical spondylosis at the molecular biology level. The relevant experimental studies are mainly on clinical research, and relatively few animal experiments have been conducted.
Tui na massage for cervical spondylosis
Tui Na method is an important part of Chinese medicine. The treatment does not require medication or injections, but only the hands of the tui-na practitioner and simple equipment to apply different techniques to certain parts of the body or acupuncture points along the route of meridians and the direction of qi and blood flow to achieve the purpose of treatment. However, it is forbidden to massage during the acute period or acute attack, otherwise it will aggravate the inflammation and edema of the nerve root and increase the pain. Cervical spondylosis with fracture, disorder of bone and joint structure, osteoarthritis, severe senile osteoporosis, etc., massage can cause bone destruction and spread of infection, so this therapy should be prohibited.
Tui na massage treatment precautions.
1, can not be arbitrary, blind, wrong massage massage. Random, blind, wrong massage massage is harmful. Cervical spondylosis is clinically divided into four types: nerve root type, spinal cord type, vertebral artery type, and sympathetic nerve type. Correct massage, massage can relieve local muscle spasm, improve local blood lymph circulation and increase the stability of the cervical spine, is one of the common treatment methods.
2, not gravity massage. However, gravity massage, especially with the nature of injury kneading method if used repeatedly in the same area, even if the operation is not strong, will cause damage to the corresponding muscle tissue or aggravate the inflammatory response, but lead to increased symptoms, patients often appear in the next morning neck pain aggravated, activity restrictions aggravated. Trigger method should also be used with caution, especially the professional level of personnel, the mastery of contraindications is not clear, reluctantly administered, may cause the patient paraplegia or even death, vertebral artery patients wrong use of trigger method may lead to fainting patients on the spot.
Identify whether the massage is suitable
Before massage, must also pay attention to identify whether the patient has other comorbidities, osteoporosis should prohibit the use of trigger method, if combined with cervical fractures, bone tuberculosis, bone tumors and other diseases is absolutely prohibited massage operation, such as combined hypertension, serious cardiovascular disease should also pay attention to the manipulation of the strength should not be too heavy.
Traction for cervical spondylosis
In clinical practice, cervical traction can be divided into sitting traction and lying traction according to the traction position; intermittent traction and continuous traction according to the traction time; small weight traction and large weight traction according to the traction weight. Generally, the cervical traction commonly used by patients are sitting small weight intermittent traction and lying small weight continuous traction. When sitting traction is used to treat cervical spondylosis, the patient sits under the traction frame with his hands on his knees. In prone traction, the patient lies on his or her back with the head of the bed elevated 20-30 cm to prevent the patient from moving in the direction of traction. Intermittent traction is performed 1-2 times a day for 60 minutes each time, and is appropriate for patients with milder conditions and in between work sessions. Continuous traction is performed in the supine position and is generally preferable to 24 hours of continuous traction, or 6-8 hours of traction per day, or traction during the day and rest at night. It is suitable for serious conditions, affecting life and workers. The so-called small weight traction means that the traction weight starts from 2 kg and generally does not exceed 7-9 kg. Large-weight traction for cervical spondylosis refers to the use of cervical traction for rapid intermittent traction, which is generally not used in clinical practice.
Surgical treatment
Surgical treatment of cervical spondylosis requires strict mastery of surgical indications, perfection of surgical principles and correct management of the occurrence of postoperative complications. Since Smith Robinson and Cloward et al. carried out anterior cervical surgery in the 1950s, the scope of surgical treatment for cervical spondylosis, surgical techniques and surgical modalities have continued to develop, and the popularity of surgery has become increasingly widespread. However, not all cervical spondylosis is treated by surgery, and most hospitalists do not recommend this method of treatment for patients with cervical spondylosis.
Advantages: Surgery is the most thorough method of treating cervical spondylosis, and in an ideal state it is possible to achieve a complete cure.
Disadvantages: traumatic, slow recovery, bleeding, high cost, easy recurrence if not properly cared for after surgery.