I. Cervical hypertension
A patient with unstable blood pressure, sometimes elevated, sometimes normal, and sometimes small differential pressure. The patient was treated as hypertension. Anti-hypertensive drugs are not less, still the same, has been high blood pressure performance. After my diagnosis, I went to the hospital for examination and found that it was the cervical spondylosis that was responsible. It turns out that this patient’s cervical small joint misalignment, compression and stimulation of the vertebral artery, resulting in spasm of the vertebral artery, insufficient blood supply to the basilar artery, reflexively increase the excitability of the vasomotor center, causing an increase in blood pressure.
The reactive edema after neck injury, interfering with the tension reflex of the neck, can also cause disturbance of the vasomotor center causing blood pressure instability, malfunction of fluid regulation, spasm and stiffness of the neck muscles, which can cause changes in neck curvature (also known as cervical physiological curvature straightening|anti-arch performance), resulting in abnormal changes in blood vessels, affecting blood supply to the brain, increasing the concentration of carbon dioxide in the brain, stimulating increased excitability of the vasomotor center, which can also It can also lead to an increase in blood pressure, which can cause hearing impairment, tinnitus, breast pain, dyspnea, chills and fever, and other symptoms that seem to be unrelated to the cervical spine.
Therefore, as a doctor, for those who have the above-mentioned symptoms, especially for middle-aged and elderly patients, before a clear diagnosis is made, it is important not to hastily “treat the headache and the foot”, but to take into account the factors of cervical spondylosis, identify the real cause and treat the symptoms.
Second, cervical spondylosis and insomnia
Insomnia is common in patients with cervical spondylosis, mainly because cervical spondylosis can cause plant nerve dysfunction. In addition, the compression of nerves, blood vessels and other tissues in the spinal osteophytes will also produce symptoms such as headache and vertigo, which will indirectly cause insomnia.
The mechanism of insomnia caused by cervical spondylosis may be related to several factors.
First, it is the pain caused by cervical spondylosis. It includes pain in the head, neck, shoulder and back, and limbs, and can also cause visceral pain in the corresponding segmental area of the cervical medulla, such as angina pectoris and stomach pain.
Second, it is due to vertebral artery lesions that make the brain blood supply impaired. The direct compression of the vertebral artery by cervical spine lesions or stimulation of the artery to make it spasm and other factors can cause the impaired blood circulation of the vertebral artery and make the cerebral blood supply insufficient.
Third, it is a disorder of plant nerve function. The cervical sympathetic nerve is not only closely related to the tissues of the cervical spine, but also spreads to the cranium, which leads to insomnia.
Third, cervicogenic tinnitus
Some tinnitus is caused by cervical spondylosis. The production of cervicogenic tinnitus is often related to the activities of the neck. When the cervical spondylosis recurs, tinnitus can be produced, and if the cervical spondylosis improves, the tinnitus also disappears. This type of disease is usually found in the white-collar class because of cervical spine damage caused by sitting in front of a computer for a long time.
Tinnitus is an abnormal sound sensation produced by people without any external stimulation. For example, people feel monotonous or mixed sounds such as cicadas, buzzing and hissing in their ears, but in fact there is no corresponding sound in the surrounding environment, which means that tinnitus is only a subjective feeling. Tinnitus can be transient or persistent. Severe tinnitus can be very disturbing and stressful. If the tinnitus is transient and comes and goes, it is generally a physiological phenomenon, so you do not need to be overly nervous and can just let it go. If the tinnitus is persistent, especially if it is accompanied by other symptoms such as deafness, vertigo and headache, you should be alert and seek medical attention as soon as possible to investigate the cause of the tinnitus.
Cervicogenic tinnitus is caused by acute and chronic injury and degenerative changes in the cervical spine, resulting in changes in the anatomical position of the cervical spine, stimulation or compression of the cervical sympathetic nerve or vertebral artery, insufficient blood supply to the vertebrobasilar artery or reflex spasm of the vagus artery, resulting in acute and chronic obstruction of blood circulation in the inner ear, thus causing “sibilance” or “buzzing” and “squeaking” tinnitus, and in severe cases, progressive, bilateral sensual tinnitus and deafness.
It can be seen that tinnitus and deafness are also one of the common symptoms of cervical spondylosis, but they rarely exist alone and are often accompanied by cerebrovascular neurological symptoms such as vertigo, vascular headache and vision changes.
IV. Blurred vision
The visual impairment caused by cervical spine lesions is called cervical visual impairment and is summarized as follows
1, eye symptoms and head and neck posture changes have a clear relationship, many people feel that the head in a particular position, eye symptoms and cervical spondylosis symptoms are reduced, while the other position are aggravated;
2. Most people have a history of cervical spondylosis, and eye symptoms and cervical spondylosis symptoms occur simultaneously or sequentially, and are closely related to changes in the condition of cervical spondylosis;
3. Ophthalmologic examinations often do not reveal the obvious cause of the disease, but the vision improves when treated according to cervical spondylosis. The reason why cervical spondylosis affects vision may be related to the plant nerve dysfunction and insufficient blood supply to the vertebrobasilar artery caused by cervical spondylosis.
It can be seen that the main treatment of this visual impairment is to cure the cervical spondylosis, cure the cervical spondylosis, vision will also be restored, if the treatment from the ophthalmology alone, it is mostly in vain.
V. Cervicogastric syndrome
The cervical spine is in the neck and the stomach is in the abdominal cavity, both of which are far apart and seem unrelated to each other. However, cervical spondylosis often “sound east and west”, so that the stomach suffers “strain”. There is a patient diagnosed by a doctor as “chronic gastritis”, manifested as epigastric distension and pain, nausea, vomiting, constipation, dry mouth, loss of appetite, poor appetite, heartburn, acidity, etc.. He took various kinds of Chinese and Western medicines for gastric diseases, but they did not work. Later, he found an experienced cervical spine specialist and examined not only the stomach but also the neck. As a result, the X-ray revealed signs of straightening of the cervical spine physiological curvature, convexity, degeneration, labral hyperplasia, narrowing of the vertebral space and bone spurs in this patient. It turned out that this patient’s stomach disease was a reflection of cervical spondylosis, which is medically known as cervicogastric syndrome.
The sympathetic nerves of the stomach belong to the autonomic nervous system. Sympathetic cervical spondylosis, stimulated or injured neck sympathetic nerve hyperfunction, and through the nervous system to the cerebral cortex, while reflexively leading to increased gastrointestinal sympathetic nerve function, so that the pyloric sphincter overstressed, over time, resulting in the pyloric sphincter diastolic weakness, myogenic expansion, prompting bile reflux, twisting the gastric mucosa and causing glandular atrophy, inflammation. This leads to a series of chronic gastritis symptoms. This gastritis is transformed with cervical spondylosis; when the symptoms of cervical spondylosis worsen, it also worsens, and when cervical spondylosis gets better, it also gets better. The principle of treatment for cervicogastric syndrome is to control cervical spine osteophytes, improve autonomic nerve nutrition, regulate autonomic nerve function, and at the same time, treat gastritis, and comprehensive treatment should not be missed.
Sixth, swallowing abnormalities
One patient often has abnormal sensation when eating hard food, and feels burning and stinging pain behind the sternum, followed by food odd swallowing. After examination of the esophagus, found to have inflammation. The problem was not solved with some anti-inflammatory drugs. Later, the hospital carefully examined again. It was found that the patient had osteophytes of the 6th cervical vertebrae and the opening of the esophagus. This section of the esophagus is relatively narrow, and the cervical vertebrae osteophytes directly compress the esophagus, causing inflammation and edema around the esophagus, resulting in a foreign body sensation in eating. The only way to eliminate esophageal inflammation is to actively treat cervical spondylosis and “untie” the esophagus in order to remove swallowing abnormalities.
Seven, cervical heart syndrome
In addition to the above common symptoms, cervical spondylosis also often involves the cardiovascular system, such as pain in the precordial region, similar to coronary angina. This is due to the stimulation or compression of the spinal cord and spinal blood vessels, resulting in sympathetic nerve cell dysfunction. In addition, inadequate blood supply to the vertebrobasilar artery causes ischemia in the cardiovascular regulatory center in the medulla oblongata, resulting in reflex coronary artery spasm contraction, which also leads to myocardial ischemia and induces arrhythmia. These cardiovascular damages caused by cervical spondylosis are collectively referred to as “cervical heart syndrome”. Anterior heart pain is called “cervical angina” and arrhythmia is called “cervical arrhythmia”. In addition to precordial pain, there may also be chest discomfort, palpitations, shortness of breath and other symptoms. In addition, it may be accompanied by an increase in blood pressure, which is associated with sympathetic nerve stimulation due to vertebral hyperplasia or aseptic inflammation of the peri-vertebral tissue.
Cervicocardiac syndrome is a cervicogenic disease, and its exact etiology is not known. Most scholars believe that the cause is a sterile inflammation caused by cervical spine and paravertebral soft tissue injury or degenerative changes such as cervical spur, bone redundancy, cervical disc herniation or cervical instability, which compresses and stimulates the nerve roots or sympathetic nerve chain and causes intricate and confusing clinical symptoms that seem to be unrelated to cervical spondylosis. The sympathetic nerve trunk in the neck is located in front of the transverse processes of the cervical spine and generally has three to four pairs of ganglia, namely the superior, middle, middle and inferior cervical ganglia. Its postganglionic fibers form the supracardiac, central and infracardiac nerves distributed to the heart, respectively. When the cervical transverse process degenerates, especially the 2nd and 3rd cervical vertebrae compress or pull the cervical sympathetic ganglion in front of them, which makes the cardiac nerves emanating from them, especially the supracardiac nerves, become more excitable and cause the coronary artery to contract and become impaired in blood supply, it can lead to clinical symptoms similar to coronary heart disease, such as pain in the precordial region, chest tightness, palpitation and shortness of breath.
Patients with cervical heart syndrome are older and have a tendency to have high lipids and atherosclerosis, and some doctors neglect to take occupational and medical histories and conduct thorough physical examinations. The main manifestation of the patient is a pinprick-like pain and distension in the precordial region, which can last for more than 15 minutes or even up to several hours. It is often accompanied by chest tightness, early arrest, palpitations, shortness of breath, changes in heart rhythm and electrocardiogram changes. Because it is a heart disease-like change caused by cervical spondylosis, it is called “cervical heart syndrome”. Because its clinical manifestations are very similar to the symptoms of coronary heart disease, it is most likely to be misdiagnosed as coronary heart disease.
Cervicolumbar syndrome
The name of “cervicolumbar syndrome” is confusing, but the real meaning of clinical differentiation and treatment is the simultaneous or sequential occurrence of spinal cord cervical spondylosis and lumbar spinal stenosis. The main clinical manifestations of cervicolumbar syndrome are the corresponding symptoms of spinal cord cervical spondylosis and lumbar spinal stenosis. Both can occur successively or coexist simultaneously, and the symptoms can be severe or mild, or both.
In fact, cervical and lumbar syndrome is the superposition of the symptoms of spinal cord cervical spondylosis and lumbar spinal stenosis, covering each other. Since both spinal cervical spondylosis and lumbar spinal stenosis can present symptoms of the lower extremities, it is difficult for doctors to identify them in terms of clinical symptoms, signs and imaging manifestations, and cervical and lumbar spine degeneration and proliferation can be found in both cervical and lumbar spine on X-ray, such as narrowing of the intervertebral space, formation of bone redundancy, degenerative cervical spinal stenosis, cervical and lumbar instability, and lumbar spine slippage. The cervical and lumbar spine can be found on CT and MRI.