Cervical spondylosis is very common among middle-aged and elderly people, with more than 70% of them suffering from varying degrees of cervical spondylosis. In recent years, I found that cervical spondylosis is getting younger and younger during outpatient visits, with about 30% of the white-collar class suffering from cervical spondylosis, and many patients aged 10 to 20 years old who are just teenagers are also common. For this reason, cervical spondylosis is brought up for discussion with you. The cervical spine is curved by seven cervical vertebrae, six intervertebral discs and the ligaments to which they belong. In order to support the head, the neck needs to have strong support and strong muscles; on the other hand, in order to adapt to the visual, auditory and olfactory stimulus responses, the neck needs to have high flexibility to maintain the coordination and balance of movements between the body and the head. However, modern work and life make many people have to adopt a sitting position all day long. Sitting life leads to a straight cervical spine, sitting life makes the neck and lumbar muscles tense for a long time because of the lack of exercise, the bones, ligaments and joints lack flexibility, the body is stiff, the function declines, and cervical spondylosis becomes the biggest obstacle affecting the ability to work. I will summarize the information about cervical spondylosis and share it with you: Chen Weijian, Department of Orthopedics, Guangdong Second People’s Hospital (1) The typology and clinical manifestations of cervical spondylosis 1, nerve root type This type has the highest incidence, accounting for about 50% to 60%. It is caused by the compression of cervical nerve root. The manifestations are radiating pain and sensory disorders in the upper limbs, numbness, allergy, inactivity and difficulty in fine movements in the fingers. The signs include limitation of cervical movement; pressure pain in the neck and shoulder; positive nerve pull test and head press test; changes in skin sensation in the area innervated by the nerve root, with pain hypersensitivity in the early stage and decompensation or disappearance in the late stage; muscle weakness and muscle atrophy, with increased muscle tone in the early stage of onset or acute attack, and decreased muscle tone and muscle flaccidity in the chronic stage. 2, spinal cord type The spinal cord is compressed by the protruding discs, vertebral body posterior edge bone superfluous, ossified posterior longitudinal ligament, hypertrophic yellow ligament and other pathological products. The clinical symptoms are numerous and include sensory, motor and autonomic dysfunction, as well as spinal nerve and vascular involvement. (1) Motor impairment. (2) Numbness of the limbs. (3) Ataxia. (4) Autonomic and sphincter dysfunction. (5) Reflex disorder. When cervical spondylosis affects the dura mater of the cervical segment, posterior longitudinal ligament, small joints, cervical nerve roots, vertebral artery and other tissues, it reflexively stimulates the sympathetic nerves in the neck and causes a series of symptoms, the pathogenesis of which is not well understood. The main symptoms are sympathetic excitation symptoms or sympathetic inhibition symptoms. (1) Head: such as dizziness, headache, migraine, neck pain, etc. (2) Eye: such as drooping eyelids, blurred vision, etc. (3) Heart: such as rapid or slow heartbeat, anterior heart pain, etc. (4) Peripheral: there may be coldness and numbness in the limbs. Excessive or little sweating of hands and feet, etc. (5) Other: including tinnitus, deafness, sublingual nerve dysfunction, etc. 4.Vertebral artery type In the transverse foramen of the cervical spine, the vertebral artery may be compressed or stimulated by its hyperplastic stenosis, narrowing of the intervertebral space, cervical instability or osteophytes of the hook vertebral joint, and the blood flow may be temporarily blocked or obstructed or infarcted due to spasm, affecting the blood supply to the brain. The following symptoms may occur: (1) vertigo; (2) headache; (3) visual disturbance; (4) sudden collapse; (5) other motor sensory or mental disturbances. 5.Mixed type is also called compound type. If two or more of the above-mentioned types of symptoms and signs exist at the same time, it can be diagnosed as mixed type of cervical spondylosis. (II) Treatment 1. Non-surgical treatment Maxillo-occipital belt traction: Applicable to all types of cervical spondylosis other than spinal cord type. Cervical brace and collar: cervical spine braking, tensioning and relieving muscle spasm. Massage: it can improve local blood supply, relax muscle spasm and relieve pain. Attention should be paid to gentle techniques and not too many times. Physiotherapy: various methods can accelerate inflammation and edema, improve blood supply to nerves and relax muscles. Self-care therapy: rationalization and adjustment of daily posture, appropriate functional exercise. 2.Medication. 3.Surgical treatment For cervical spondylosis with a clear diagnosis that is invalidated by non-surgical treatment or repeatedly occurs, or for cervical spondylosis of spinal cord with progressive aggravation of symptoms, surgical treatment is suitable. 4.Surgical route: anterior, anterolateral and posterior surgery. 5.Anterior and anterolateral surgery: It is suitable for removing the herniated intervertebral disc, posterior vertebral body bones and juncture bones to release the compression on the spinal cord, nerve roots and vertebral artery. At the same time, intervertebral fusion with bone graft can be performed to stabilize the spine. 6, posterior surgery: mainly through laminectomy or laminoplasty to achieve the decompression of the spinal cord. When not much laminectomy can be done to achieve decompression, posterior spinal fusion can also be supplemented. Many people suffering from such diseases often ask questions in this regard, mainly focusing on two aspects: 1. how to treat cervical spondylosis and how many treatment options are available. 2. how much does treatment cost in Guangzhou? I summarize the answer to the question as follows: treatment of cervical spondylosis, about 85% can be cured by conservative methods. However, it cannot be eradicated and often recurs. The cost of each treatment varies according to the severity of the attack and is difficult to estimate. Minor cervical spondylosis can be treated with minimally invasive surgery. Our hospital applies minimally invasive means such as laser melting disc, ozone and clamping, and the treatment process takes about 2-3 days, with small incisions and less pain, and the cost of surgery is about 5,000-8,000 yuan according to the current situation in Guangzhou. Whether or not to open the surgery directly is mainly based on the symptoms. If there is nerve function affected, such as the appearance of numbness of the limbs, weakness, incontinence, etc., it means that the nerve compression has been more serious, and it is necessary to do surgery to release the nerve compression, and in a timely manner, because it is difficult to recover from degenerative necrosis after nerve compression. Most of the cervical spondylosis must remove the intervertebral disc to release the nerve compression, at the same time should be plate fixed cervical spine, at the same time to use general anesthesia, the cost of surgery is more expensive, about 40,000-50,000 yuan. Because of the complex structure of the cervical spine, the compression or strain of the cervical spine can easily manifest as different symptoms, and therefore it is very easy to cause misdiagnosis. Some people will feel dizzy, some will have numbness in their arms, some will have back pain, and some will have stomach pain, chest tightness and shortness of breath, or cause severe laryngitis, etc. Also the treatment of cervical spondylosis is somewhat complicated and must be done according to the situation, for example, those with spinal stenosis should avoid tui na massage or traction, while those with herniated discs should instead be traction. Therefore, patients are required to find the cause of the disease and treat the cause, not to “headache, foot pain”. It is best to consult a professional orthopedic surgeon to provide more comprehensive advice. Do not seek medical advice indiscriminately, which will cost you money and delay treatment. In daily life, attention should be paid to the prevention of cervical spondylosis, of which exercise is the best way to treat cervical spondylosis. From the anatomical point of view, the muscle groups of the whole body are almost radially closely related to the cervical spine, and any exercise is an exercise for the coordination and balance of the whole body, so it will make the cervical spine get exercise. Under the premise of preventing sports injuries, it is very beneficial to increase the frequency and intensity of exercise appropriately. The easiest way to do this is to “look at the moon” and often do the backward movement of the neck to help relieve muscle fatigue.