Cervical spondylosis 1, cervical spondylosis definition cervical spondylosis full name: cervical osteochondrosis, English (Cervical spondylosis) refers to a variety of degenerative changes in the cervical vertebrae, cartilage, muscles, ligaments and other degenerative changes due to intervertebral disc degeneration, so that the cervical spinal cord, nerve roots and blood vessels and other surrounding tissue damage and clinical syndrome is also known as cervical spine syndrome. It is a common disease among middle-aged and elderly people, but now it is also common among young people, and cervical spondylosis is gradually becoming a trend of youth. 2, cervical spondylosis cause and pathology of the cervical spine because of work, life, trauma and other factors, coupled with frequent activities, and more weight bearing, but the anatomical structure is relatively weak, so easy to strain, and long-term strain is the main cause of a series of degenerative changes in the cervical spine, the result is that under the influence of some external force rupture of the annulus fibrosus and nucleus pulposus protrusion or disc atrophy, narrowing of the intervertebral space. The intervertebral ligaments gradually relax, and the intervertebral joints lose stability, easily causing misalignment injury. Over time, the vertebral bone edge osteophytes, ligament hypertrophy, calcification, adhesions, joint dislocation and other compression and stimulation of the surrounding vascular nerves and other tissues to produce the corresponding clinical symptoms. In recent years, more young patients are found in the clinic, even if the degeneration of cervical spine is light, it can also cause more serious clinical symptoms. The clinical manifestations of cervical spondylosis are complex, and the cervical spine is divided into six types according to different tissue structures and symptoms: cervical, neurogenic, spinal cord, vertebral artery, sympathetic nerve and mixed. (1) Cervical cervical spondylosis: clinical performance characteristics of neck pain, often the first symptom of cervical spondylosis, the acute onset of the commonly known as “pillow” accounted for 80% of cervical spondylosis, the duration of this type of disease is more long, sometimes light and sometimes heavy, can last for several months to several years. Clinical symptoms are mostly triggered by improper head and neck position during sleep, cold or sudden twisting of the neck during physical activity, with persistent soreness or pain, aggravated by head movement, spreading to the back of the shoulders and the upper limbs behind the head, pain accompanied by a sense of neck stiffness, and ringing in the neck when turning, with obvious pressure pain in the neck, without neurological dysfunction, and X-ray examination often showing changes in curvature. (2) Neurogenic cervical spondylosis: The neurogenic type mainly develops in middle-aged and elderly people, and the incidence is second only to the cervical type. The cause is mainly due to nerve compression and stimulation caused by lesions of the cervical spine, intervertebral foramen, adjacent tissue adhesions and joint misalignment, among which cervical 5, 6 and 7 nerve involvement is common. The symptoms are electric shock-like radiation from single or several nerve roots on the affected side from the neck to the shoulder, arm, forearm and hand, often with drilling pain or cutting pain, and most of them can also show sensations such as heaviness and weakness of the affected upper limbs and numbness. On examination, the patient’s neck is stiff, movement is limited, the cervical physiological foreshortening becomes smaller, there are multiple pressure points in the neck, and the most diagnostic significance is the radiological pressure pain on both sides of the corresponding cervical spine. Head pressure test, supination test, brachial plexus nerve entrapment test are often positive, X-ray examination, cervical physiological pronation decreases or disappears, vertebral space narrows, hook spine joint spur, intervertebral foramen narrows, a few have changes such as vertebral body or joint dislocation Neurogenic cervical spondylosis clinical manifestations distribution table: cervical vertebral body gap involvement nerve root radiation site sensory impairment area muscle weakness and atrophy cervical 4-5 cervical 5 along the top of the shoulder to the lateral upper arm cervical 4.5 triceps neck 5-6 neck 6 along the top of the shoulder, lateral forearm dorsal to the mother finger and the index finger neck 4-6 biceps neck 6-7 neck 7 along the posterior lateral upper arm, dorsal forearm to the middle finger neck 6.7 triceps neck 7-thoracic 1 neck 8 along the medial upper arm, ulnar side of the forearm to the little finger neck 7 small muscles of the hand (3) spinal cord type cervical spondylosis: spinal cord type is less common, mainly after the onset of more than 40, the pathology is the posterior cervical vertebral body bony The pathology is a herniated disc, calcification of the posterior longitudinal ligament, hypertrophy of the ligamentum flavum and reactive peridural inflammation, which cause mechanical compression of the spinal cord and arteries, resulting in clinical symptoms of spinal cord compression with slowly progressive numbness, coldness, pain, unstable walking, trembling muscle weakness with cotton or sponge-like sensation, etc. A few may feel numbness all over the body due to violent head tilting, weakness of the legs, reduced by bed rest, and at the same time Weakness of limbs, tightness, urinary and faecal disorders, inflexible movements, incomplete spastic paralysis, some patients may be combined with nerve root vertebral artery and sympathetic type symptoms. Examination: the sensory and motor impairment of the spinal conduction tracts of the limbs can be seen bilaterally, muscle strength is reduced, muscle tone is increased, tendon reflexes are hyperactive, ankle, hip and pathological reflexes are positive, there is no radiological pain, coughing is aggravated.