1. Current status of development of sympathetic cervical spondylosis.
Sympathetic cervical spondylosis is a type of cervical spondylosis, but there is no detailed report of such a typology in the foreign literature. As a common type of cervical spondylosis, the number of incidences has been increasing year by year in recent years, which may be related to the popularity of computers and the accelerated pace of society, where people spend longer time with their heads down. The disease is characterized by patients with many complaints but few objective signs and complex symptoms, including two main categories.
The first category is sympathetic excitation symptoms, which are more common and mainly include.
(1) Head symptoms: manifesting as headache and migraine, the pain is mainly located in the occipital region and forehead, dull pain in nature, often accompanied by dizziness, mental confusion, drowsiness, memory loss, some patients are also accompanied by nausea, and rarely vomiting;
(2) Ocular symptoms: blurred vision, enlarged eye fissures, dilated pupils, painful swelling of the fundus, and dry eyes;
(3) Cardiovascular symptoms: transient tachycardia and increased blood pressure;
(4) Ear symptoms: tinnitus, hearing loss;
(5) Others: chills and fear of cold in the limbs, little sweating on one limb, numbness in the head and face or limbs, etc.
Type II is sympathetic inhibition symptoms with rare manifestations, such as drooping eyelids, lacrimation, nasal congestion, bradycardia, decreased blood pressure, etc.
2. Definition of sympathetic cervical spondylosis
Barre-Lieou proposed “posterior cervical sympathetic syndrome, Barre-Lieou syndrome”: a series of symptoms due to stimulation of sympathetic nerves in the neck, resulting in vertebral artery spasm with ischemic changes in the vertebrobasilar artery.
Barre describes posterior cervical sympathetic syndrome and its etiology: chronic cervical osteoarthropathy. The syndrome includes: occipital pain, nystagmus with head movements, tinnitus, blurred vision, and corneal sensory sensitivity. Other symptoms are: anxiety, depression, memory-cognitive disorders, cervical sympathetic disorder caused by trauma and degeneration of C3, 4 and intervertebral discs. barre-Lieou syndrome, in fact, is sympathetic cervical spondylosis, and there is no substantial difference between the two.
3.Pathogenesis
The pathogenesis of sympathetic cervical spondylosis is still not clear. Wei Wei et al. believe that the theory of cervical sympathetic nerve stimulation can explain it, and in recent years, some scholars believe that cervical instability is the most important cause of sympathetic cervical spondylosis. In addition to intervertebral disc degeneration, cervical instability caused by non-degenerative factors such as myotonic imbalance due to trauma causes abnormal local mechanical stimulation and traumatic inflammatory stimulation of the intervertebral joints triggers cervical sympathetic symptoms. Ischemic changes in the distribution of the vertebral artery occur when the sympathetic nerve is provoked. Much clinical evidence suggests that mechanical compression may not be the underlying cause of vertebrobasilar artery ischemia, but rather that sympathetic irritation is the primary cause.
4, Treatment
4.1 Functional exercise
The pathogenesis of cervical spondylosis is mainly cervical instability, and some scholars suggest that sympathetic cervical spondylosis images show that cervical instability is more common in C3, 4, C4, 5, and some may not show any performance. Strengthening the strength of the neck muscles can reduce the stress on the cervical intervertebral discs and small joints of the cervical spine, which also reduces mechanical and inflammatory stimulation and is necessary to maintain the stability of the cervical spine. The method is to hold the pillow with both hands, so that the hands and the posterior cervical muscle confrontation, each confrontation 15 ~ 20 s, relax 2 ~ 5 s, repeatedly perform the above actions, each exercise 15 ~ 20 min, 2 ~ 4 times a day.
4.2 Traction therapy
Cervical traction can not only reduce the pressure of intervertebral discs and expand the intervertebral space and hook vertebral joints, but also stabilize the cervical spine and restore the balance within the cervical spine. More importantly, it can reduce the pressure and stimulation of sympathetic nerve fibers in the intervertebral disc and the hook vertebral joint, which is conducive to functional rehabilitation. Traction can be performed in a seated or supine position with occipito-mandibular set traction, generally at 5 to 6 kg, and should not be too heavy. Traction time is generally 15-25 min, twice a day, and 20-30 times a course of treatment. Some scholars simulated the cervical spine model according to the mechanical characteristics of the cervical spine combined with clinical measurements, the location of the maximum stress differs with different traction angles. The maximum stress is in the upper part of the cervical spine when the traction angle is small, and in the lower part of the cervical spine when the traction angle is large. The angle of traction should change with the change of cervical spine physiological curvature. Clinical symptoms can be aggravated by unsuitable angles.
In order to save time, under the guidance of experts, you can also choose a suitable traction device to traction by yourself.
4.3 Choose a healthy pillow
The yuanbao-shaped health pillow with low middle and high ends has good support for the cervical spine, which can give the cervical spine a better rest. At the same time, the width of the pillow should reach the shoulders. For people with bad cervical vertebrae, plank beds and brown-brown bandage beds are preferred.