Cervical spondylosis is a comprehensive disease, also known as cervical spine syndrome. It is a set of comprehensive symptoms stimulated or caused by the gradual degeneration of human cervical discs, cervical spine osteophytes, or changes in the normal physiological curve of the cervical spine. These patients often feel numbness in the head, neck, shoulders and arms, and in severe cases, it can lead to limb weakness and even urinary and fecal incontinence and paralysis.
Cervical spondylosis has a tendency to become younger in recent years, especially for those who are engaged in long-term accounting, securities, IT, teaching and writing work, as well as for those who work on assembly lines, whether they are white-collar or blue-collar workers, or even students, almost all need to work in a fixed posture of the head and neck, which seems to be unavoidable. The cervical spine is in a flexed position or some specific position for a long time, which not only increases the pressure in the cervical disc, but also puts the neck muscles in an uncoordinated stress state for a long time, and the muscles and ligaments at the back of the neck are susceptible to strain and strain, all of which are prone to cervical spondylosis.
How many kinds of cervical spondylosis are there?
1.Neurogenic type: The incidence is the highest, and most of the so-called cervical spondylosis or neck and shoulder pain refers to this type. This is caused by the protrusion of the cervical shoulder disc to the posterior and lateral side, or the compression and stimulation of the cervical nerve root due to the growth of bone spurs. It is characterized by radiating pain and sensory disorders in the upper extremities, numbness of the fingers, foreign sensation, and inflexibility of movement. It can be aggravated by head tilting, coughing and sneezing. Early onset of the disease can be brought to the attention of the patient, the earlier the patient goes to the doctor, the better the outcome, about 90% of the patients can be self-healing.
2. Spinal cord type: about 15% of patients have this type. When osteophytes occur, or thickening or ossification of the ligaments connecting the bones and joints, the spinal cord and blood vessels can be compressed, and even ischemia or necrosis of the spinal cord can occur. Most of the patients develop the disease after middle age in a “recessive” form, and the early clinical stage is unilateral or bilateral lower limb numbness, which later develops into walking difficulties and urinary and fecal dysfunction or even paralysis.
3, sympathetic nerve type: about 5%. The symptoms are caused by the compression of sympathetic nerves in the neck. Because of its wide distribution, it can cause symptoms in many organs and systems. Including.
(1) Head symptoms: dizziness, headache, posterior neck pain.
(2) Eye symptoms: droopy eyelids, blurred vision, and even blindness.
(3) Cardiac symptoms: rapid or slowed heartbeat, heartburn.
(4) Peripheral symptoms: numbness or pain in the limbs, head, neck, and face.
(5) Other: tinnitus, deafness, etc.
4.Vertebral artery type cervical spondylosis: about 2%. It is a series of symptoms caused by external compression or stimulation of the vertebral artery, resulting in dysfunction and insufficient blood supply to the brain. More than half of the patients have a sudden onset of the disease, which can be asymptomatic and without any premonition. Sometimes it is accompanied by headache, nausea and vomiting, ringing in the ears and blurred vision.
The symptoms that can be clearly identified as cervical spondylosis are as follows, and any one of the following indicates cervical spondylosis
Pain in the back of the neck, which can be relieved by pulling the head and neck upward with the hand, but is aggravated by applying pressure downward Neck pain accompanied by radiating pain or (with) numbness in the upper limbs (including the hands) (mostly neurogenic cervical spondylosis). Rotation of the head and neck to the left and right when the eyes are closed, triggering migraine or vertigo (mostly vertebral artery cervical spondylosis). The neck pain is accompanied by muscle weakness and muscle pain in the upper or lower extremities (mostly spinal cord cervical spondylosis or combined cervical spinal stenosis). When lowering the head, the whole body suddenly becomes numb or has an “electric” sensation (mostly spinal cord type cervical spondylosis, especially in combination with severe cervical spinal stenosis).
Second, the treatment of cervical spondylosis
Non-surgical treatment of cervical spondylosis: Non-surgical treatment is also called the integrated therapy of Chinese and Western medicine. It is the most basic therapy for cervical spondylosis. It includes cervical traction, physiotherapy, massage, acupuncture, drugs, neck brace and medical sports and self-therapy. Non-surgical treatment can reduce the symptoms of cervical spondylosis, improve significantly, and even cure it. It is especially beneficial to patients with early cervical spondylosis. In addition, non-surgical therapy can lay a good foundation for surgical therapy. This is because cervical spondylosis is accelerated by various additional factors on top of the degeneration of the body. Therefore, in order to slow down or reverse this process, a series of preventive and therapeutic measures must be taken, which is the most basic and effective measure for cervical spondylosis, so non-surgical therapy is the basic therapy for the disease.
Third, which patients need surgical treatment?
1, cervical disc herniation by non-surgical treatment after the radicular pain is not relieved or continues to aggravate, seriously affecting life and workers.
2.Cervical spondylosis with symptoms of spinal cord compression and partial or complete obstruction by myelography with iodine oil.
3.Patients with cervical spondylosis who have sudden cervical trauma or acute spastic paralysis of limbs without obvious trauma.
4.Cervical spondylosis causes repeated cervical vertigo, syncope or sudden collapse, and the non-surgical treatment is ineffective.
5.Cervical spondylosis with clear sympathetic nerve symptoms, which is ineffective by non-surgical treatment and seriously affects workers.
6, cervical spondylosis vertebrae in front of the bone superfluous causes symptoms of esophageal or laryngeal recurrent nerve compression, such as swallowing difficulties
Fourth, cervical spondylosis is only neck and back pain?
People generally think that cervical spondylosis is nothing more than neck and back pain. It is not known that the cervical vertebrae are attached to the skull and the trunk, and the neurovascular distribution is intertwined and dense, and it is an important part of the human nerve center and the path of cerebral blood circulation, so it is an accident-prone area of the human body. Once the disease occurs, it will certainly affect the cardiovascular and central nervous system, resulting in all kinds of cervicogenic diseases, which can be said to involve a hair and move the whole body.
After middle age, cervical disc degeneration aggravates, which can cause adjacent nerves, blood vessels and spinal cord to be compressed, resulting in intricate and variable symptoms, namely cervical spondylosis. The anterior flexion activity of cervical spine is centered on 4-5 and 5-6 cervical spine, and the posterior extension activity is centered on 4-5 cervical spine, and the lower cervical segment is subject to the greatest and more concentrated stress in cervical spine activity, so clinically 4-5, 5-6 and 6-7 cervical intervertebral disc degeneration occurs earliest and most often. After acute or chronic injury to the intervertebral disc, a post-injury repair response occurs, resulting in the formation of a mixed herniation consisting of a bone flab with the damaged disc tissue and the posterior longitudinal ligament.
When it protrudes posteriorly, it compresses the nerve root and produces symptoms of nerve root compression and irritation; when it protrudes laterally, it compresses the vertebral artery or stimulates the sympathetic nerve and produces symptoms of insufficient blood supply to the vertebral artery or sympathetic nerve; when it protrudes posteriorly, it compresses the spinal cord and produces symptoms of spinal cord compression; when the protrusion lies between the above-mentioned different parts and compresses and stimulates different tissues at the same time, it can produce mixed symptoms.
Clinically, cervical spondylosis is generally classified into five types: neurogenic, vertebral artery, sympathetic, spinal cord, and mixed. In addition, there are some not uncommon types that appear to be “unrelated” or even confusing to cervical spondylosis, which often lead to misdiagnosis and mismanagement.
1, cervicogenic hypertension: Due to the derangement of the blood supply of the vertebrobasilar artery, the sympathetic nerves in the neck are stimulated, resulting in dysfunction, and in addition to the general symptoms of cervical spondylosis, there is hypertension. These diseases are not treated according to hypertension, and the blood pressure drops after the symptoms of cervical spondylosis are controlled.
2, cervicogenic cerebrovascular disease: 26% of the nearly 1 million cerebrovascular patients in the country each year are induced by cervical spondylosis. This is due to the compression of the vertebrobasilar artery, resulting in insufficient blood supply to the brain, long-term maintenance of this state, there will be dizziness, numbness of the hands and feet, unstable walking, and even cerebral thrombosis, cerebral infarction, some patients can lead to hemiplegia. If cervical spondylosis is treated in time, it will not deteriorate into serious consequences such as stroke and hemiplegia.
3, cervicogenic angina: If you suffer from “angina”, the general drug treatment does not work, you should think about whether it is due to cervical spondylosis. This is due to damage to the cervical nerve roots that innervate the diaphragm and pericardium, or to stimulation of the sympathetic nerves of the heart. The patient may experience pain in the precordial region, and pressure on the pressure area near the cervical spine can induce pain. When the head is in a specific position and posture, the symptoms can be aggravated, and reduced after changing the position, and treatment according to cervical spondylosis can receive obvious results.
4, cervicogenic gastritis: due to cervical sympathetic nerve stimulation or injury, resulting in hyperfunction, through the cerebral cortex and thalamus reflexively caused by gastrointestinal sympathetic nerve function excitement, excessive tension of the pyloric sphincter, diastolic weakness, so that the stomach, duodenum retrograde peristalsis, prompting bile reflux and damage to stimulate the gastric mucosa, thus causing acute or chronic inflammation of the stomach.
5, cervicogenic tachycardia: cervicogenic dysphagia such conditions are due to the rapid rate of osteophyte growth of the lower cervical vertebrae, the bone superfluous, compression of the esophagus immediately in front, inflammation, edema and cause narrowing of the reason, clinically very easy to misdiagnose as esophageal disease.
Thus, when some patients often have headache, toothache, trigeminal neuralgia, vertigo, nausea, vomiting, insomnia, irritability or mental depression, visual and hearing impairment, abnormal taste and smell and skin sensation, cardiac arrhythmia and other symptoms and ineffective treatment, it is worth checking the cervical spine, do not “headache doctor, foot pain doctor”, because the lesion It is likely to be in the cervical spine.
Five, why will get cervical spondylosis
1, the age factor: like a machine, with the growth of age, the wear and tear of the human body parts are increasing, the cervical spine will also produce a variety of degenerative changes, and degenerative changes in the intervertebral disc is the most basic and critical basis for the development of cervical spondylosis. In addition, the degeneration of small joints and various ligaments also have an important role to play.
2, chronic strain injury: is a variety of more than the normal range of excessive activities brought about by injury, such as poor sleep, improper height of the pillow or improperly padded parts, repeatedly fallen pillow also has a higher prevalence. In addition, improper work posture, especially the incidence of cervical spondylosis is particularly high in long-term low-headed workers. In addition, some inappropriate physical exercise will also increase the incidence, such as the inappropriate inversion, somersault, etc.
3, trauma: on the basis of cervical spine degeneration and instability, head and neck trauma is more likely to induce the generation and recurrence of cervical spondylosis. Patients often have sudden onset after minor trauma, and the symptoms are often heavy, and the combination of fracture and dislocation adds difficulties to the treatment.
4, pharyngeal inflammation: When there is acute or chronic inflammation in the throat or neck, the inflammatory edema of the surrounding tissues can easily induce the appearance of cervical spondylosis symptoms, or aggravate the condition.
5, developmental spinal stenosis: those with spinal stenosis are more likely to develop cervical spondylosis, and the prognosis is relatively poor.
6, congenital malformation of the cervical spine: various congenital malformations, such as congenital vertebral fusion, skull base depression and other conditions are easy to induce the occurrence of cervical spondylosis.
7, metabolic factors: due to various reasons caused by human metabolic disorders, especially calcium, phosphorus metabolism and hormone metabolism disorders, often easy to produce cervical spondylosis.
8, mental factors: from clinical practice found that bad mood often aggravate cervical spondylosis, and cervical spondylosis aggravation or attack, the patient’s mood is often worse, easily agitated and tantrums, cervical spondylosis symptoms are also more serious.
Six, how to do with cervical spondylosis?
Cervical spondylosis is a chronic degenerative disease. Its clinical manifestations are diverse, especially the pushing pulse type and sympathetic nerve type cervical spondylosis, and sometimes it is not easy to confirm the diagnosis. Once you have symptoms in this area, you must ask a specialist to help confirm the diagnosis, otherwise the diagnosis will be delayed and treatment will be delayed. Once the diagnosis is clear, the following aspects should generally be noted.
1, to have a correct understanding of the disease, establish confidence in overcoming the disease: cervical spondylosis has a long course, pushing the degeneration of the intervertebral disc, the growth of bone spurs, ligament calcification and other related to ageing, the aging of the body. The disease is often recurrent, and the symptoms may be heavy during the attack, affecting daily life and rest. Therefore, on the one hand, we must eliminate the fear of pessimism, and on the other hand, we must prevent the mentality of getting by and giving up active treatment.
2.About rest: Patients with acute attack or first attack of cervical spondylosis should pay proper attention to rest, and those with serious condition should take bed rest for 2-3 weeks. Bed rest has an important role in relaxing the neck muscles, reducing muscle spasm and the pressure of the head weight on the intervertebral discs, and the decreasing of tissue pressure edema. However, bed rest should not be too long to avoid changes such as muscle atrophy, tissue adhesions and joint adhesions, which hinder the recovery of cervical spondylosis. Therefore, in the interval and chronic period of cervical spondylosis, it is appropriate to participate in work. Long-term rest is not required.
3, about maintenance: the human body is especially like a complex machine, from time to time need to be maintained. Especially cervical spondylosis, itself is a degenerative pathology, but also to protect the neck, try to avoid unnecessary damage. Whether it is sleep, rest, or study and work, and even some daily movements, we must maintain good habits and never forget the protection of the cervical spine. At the same time, strengthen the exercise of the cervical muscle.
4, about treatment: the treatment of cervical spondylosis is divided into non-surgical treatment and surgical treatment. The vast majority of patients can be relieved by non-surgical treatment or even cured without occurrence. However, each treatment method has its unique operation, role and indications, and requires the guidance of a specialist physician, and there is a certain course of treatment. Do not rush to seek medical help, and frequently change the treatment method or use a variety of methods in a haphazard manner, not only to get the treatment effect, but also to aggravate the disease.
Seven, cervical spine disease illusion more
The cervical spine is occupied by the nerve center to and from the brain, from which the sensations of various parts of the body are transmitted to the general headquarters – the brain. Because of the large amount of movement and special location here, after middle age will enter the eventful season. However, some patients are often misdiagnosed as eye disorders, esophageal cancer, cardiovascular disease, hysteria, etc. for a long time after the onset of the disease.
The following symptoms are easily misdiagnosed.
1. Dysphagia: According to a foreign medical journal, a 65-year-old man began to feel itching in his throat with a foreign body sensation, and later felt difficulty in swallowing, with intermittent episodes, sometimes light and sometimes heavy, most obvious when turning his head to the left, accompanied by nausea and vomiting. The patient had consulted the gastroenterology department and was suspected of having esophageal cancer, but the gastroscopy was normal. Later, a CT tomography scan showed that the osteophytes at the anterior edge of the cervical spine were compressing the esophagus. According to the clinical statistics in recent years, about 1.6% of patients with cervical spondylosis have this manifestation.
2, hypertension: cervical spondylosis can cause an increase or decrease in blood pressure, but the former is more common, called cervical hypertension. This is related to the stimulation of sympathetic nerves by the bone. Patients are often accompanied by neck pain, tightness, upper limb numbness and other typical manifestations.
3. Breast pain: It is caused by the nerve roots of the 6th and 7th cervical vertebrae compressed by the hyperplastic bone. It starts with pain in one side of the breast or the pectoralis major muscle, intermittent vague pain or paroxysmal stabbing pain, which is most obvious when turning the head to one side, and sometimes the pain is unbearable. If this pain occurs on the left side, it is easily misdiagnosed as angina pectoris, while the right side is easily misdiagnosed as pleurisy.
4. Lower limb paralysis or defecation disorder: it is caused by the stimulation of the lateral bundle of the spinal cord. Patients with upper limb numbness, pain and weakness, limping, and most of the symptoms in the neck are mild and easily masked. Some are accompanied by urinary frequency, urinary urgency, urinary incontinence or urinary and fecal incontinence.
5, visual impairment: cervical spondylosis can also manifest as vision loss, intermittent blurred vision, distention and pain in one or both eyes, photophobia, tearing, narrowing of visual field, and in severe cases, blindness. This visual impairment is related to the plant nerve dysfunction caused by cervical spondylosis or ischemia in the visual center of the brain. According to statistics, 0.67% of cervical spine patients have eye performance, but most of them have other symptoms of cervical spondylosis.
6, sudden fall: caused by the compression of the vertebral artery by the hyperplastic bone, easily misdiagnosed as cerebral arteriosclerosis or cerebellar disorders. The body often loses support and falls suddenly when the head is suddenly twisted during walking, and then wakes up and stands up after the fall because of the change of neck position, without coma, but mostly accompanied by severe vertigo or headache, nausea, vomiting, sweating and other symptoms.
Eight, confusing cervical spondylosis
After middle age, the function of the body begins to decline, and the cervical intervertebral disc can degenerate and rupture, thus often causing narrowing of the cervical nerve foramen and vertebral artery foramen due to narrowing of the vertebral space and osteophytes, thus compressing or stimulating the cervical nerve root and vertebral artery and producing cervical spondylosis.
Currently, the medical profession classifies cervical spondylosis into five types.
1.Superior segment type: When the lesion occurs, it causes numbness and swelling pain in the back of the neck and behind the ear, accompanied by dizziness, headache, vomiting, hearing and vision loss, and in some cases, even fainting.
2.Middle segment type: The lesion causes muscle atrophy of the posterior cervical and paravertebral muscles, paralysis of the diaphragm, and in some cases, stuffy pain in the precordial region and plant nerve dysfunction.
3, lower segment type: scapular, back pain, upper limb pain, forearm muscle atrophy, finger numbness.
4, spinal stenosis type: mostly due to cervical spine hyperplasia, ligament thickening, intervertebral disc protrusion in the central part of the spinal canal and other reasons caused by the narrowing of the spinal canal, compression of the spinal cord caused by the anterior horn cell damage, the appearance of limb movement disorders. In the early stage, the first is unstable walking and staggering gait; in the later stage, the lower limbs become stiff, called spasticity, and some people call this spinal cord type.
5.Mixed type: The above two types appear at the same time.
However, it is not so easy to clinically confirm the diagnosis of cervical spondylosis, and the symptomatic manifestations of the onset of some people are very complicated and seem confusing.
1, many patients with cervical spondylosis often have angina pectoris as the first symptom. Such angina attacks are often accompanied by typical signs and symptoms of cervical spondylosis. Oral cardiac pain, nitroglycerin and other drugs for angina are ineffective. The cause is due to cervical spine osteophytes, so that the nerve roots innervating the diaphragm and pericardium are stimulated, or therefore stimulate the sympathetic nerve of the heart.
2, there are some “stomach disease” patients by a variety of drug treatment, but it is difficult to get results, and cervical spine disease symptoms improve, “stomach disease” symptoms also corresponding relief or alleviate. This is due to cervical spine osteophytes constantly stimulating or damaging sympathetic nerves, causing cervical sympathetic nerve hyperfunction, which reflexively leads to increased intestinal sympathetic nerve function, and causes pyloric sphincter diastolic weakness, prompting bile reflux, damage to the gastric mucosa, causing inflammation, some scholars call this “cervical gastric syndrome”.
3, some middle-aged and elderly women see unilateral breast pain, and there is pain and discomfort in the neck, occipital, shoulder and arm. This is caused by the restricted movement of the neck and the change of muscle strength, sensation and reflex of the involved nerve root innervated segments.
4, cervical spondylosis can also cause abnormal changes in blood pressure, which includes making the blood pressure increase or decrease, with elevated blood pressure being the most common clinically. The cause is mainly the misalignment or hyperplasia of the small joints of the cervical spine, resulting in spasm of the vertebral artery and insufficient blood supply to the vertebral basilar artery, which reflexively increases the excitability of the vasomotor center and causes an increase in blood pressure. Or due to the blood supply to the neck, the brain tissue is deprived of oxygen, resulting in elevated blood pressure. Therefore, when unexplained elevated blood pressure occurs in middle-aged and elderly people and treatment with antihypertensive drugs is ineffective, it is advisable to check the cervical spine in the hospital.
9. Diagnosis of cervical cervical spondylosis
The diagnosis of cervical cervical spondylosis is generally not difficult, even without X-ray film, the diagnosis can also be based on the onset characteristics alone. Note that sometimes cervical sprain and fibrous tissue inflammation of the neck and shoulder may also show symptoms similar to those of cervical cervical spondylosis, which must be distinguished.
10. How is vertebral artery cervical spondylosis diagnosed?
Ischemia can be caused by lesions in any of the four segments of the vertebral artery, and the symptoms are similar, mainly as follows.
1. Migraine: about 70% of patients have migraine, often triggered by sudden rotation of the neck, which is obvious at the temple and often manifests as throbbing pain or stabbing pain. Generally, it is unilateral, but if the vertebral artery is compressed bilaterally, it will show bilateral symptoms.
2. Labyrinthine symptoms: This is a manifestation of the violation of the inner ear, mainly tinnitus and hearing loss. 80%-90% of patients have this phenomenon, which is very common and is mainly due to the obstruction of the blood flow of the vertebral artery and the insufficient blood supply of its branch inner ear arteries.
3. Vestibular symptoms: The vestibule is a part of the inner ear and insufficient blood supply can cause vertigo, which is present in 70% of patients on average. It arises, develops and intensifies in direct relation to the rotational movements of the neck.
4. Memory loss: It is also caused by insufficient blood supply, with an incidence of 50%. Patients treated, especially surgically, often feel “clearer” just after the surgery (decompressive surgery of the vertebral artery).
5, visual impairment: about 40% of patients have vision loss, blurred vision, diplopia (i.e. double vision), hallucinations, and even transient blindness, which is mainly caused by ischemia in the visual center of the occipital lobe of the brain and the third, fourth and sixth nuclei and medial tracts of the brainstem.
6, psychiatric symptoms: neurasthenia is the main manifestation, accounting for about 40% of the cases, the majority of depressed people, less euphoric people; and more often accompanied by forgetfulness of recent events, seizure and dreamy phenomenon.
7, dysarthria: less common, accounting for about 20%. The main manifestations are slurred speech, hoarseness and numbness of the lips and mouth, etc. In severe cases, dysphonia can occur and even affect swallowing. This is mainly due to the ischemia of the medulla oblongata and cerebral nerves.
8. Sudden fall: that is, sudden fall with severe spasm of vertebral artery, which causes transient ischemia at the conus intersection. The process of seizure is roughly as follows: when the patient is in a certain position of head and neck rotation, suddenly feel dizziness, headache, the patient immediately hold the head, legs weakness, and then fall to the ground. There are no signs and symptoms before the attack, and the patient can get up by himself after the fall because there is no impairment of consciousness during the attack. The incidence is 10-20%.
Since there are a large number of sympathetic postganglionic fibers around the vertebral artery, when the vertebral artery is irritated, compressed or flexed, the sympathetic fibers there are bound to be affected and cause various symptoms. Clinically, gastrointestinal, respiratory and cardiovascular symptoms are the most common. In individual cases, Horner’s syndrome may appear, manifesting as pupillary constriction, eyelid ptosis and eye entropion.
Since vertebral artery cervical spondylosis is a type of cervical spondylosis, it must be accompanied by the general symptoms of cervical spondylosis, such as neck pain, posterior occipital pain, and limitation of neck movement. If the lesion also affects the spinal cord or spinal nerve roots, the corresponding symptoms may appear. The imaging examination can also reveal some characteristic changes.
9.X-ray plain film: orthopantomographs reveal hyperplasia of the hook joint, lateral oblique films show narrow intervertebral foramina, and power lateral films taken in forward flexion and supination can reveal abnormalities such as unstable trapezoidal changes of vertebral segments, bone spur formation, or vertebral deformities.
10, magnetic resonance (MR): mainly observe the state of the intervertebral disc, whether there is protrusion and the direction of protrusion; the site of the bone spur and the surrounding spinal cord, whether there is pressure phenomenon; the size of the transverse foramen on both sides, whether there is deformation.
11, vertebral artery magnetic resonance: that is, the vertebral artery as the main body of the magnetic resonance examination, can clearly show the thickness of both sides of the vertebral artery, travel (with or without bending and narrowing).
Digital subtraction angiography (DSA) of the vertebral artery is also one of the methods to examine the vertebral artery, which requires puncture and cannulation during the examination and has certain damage.
XI. Diagnosis of spinal cord type cervical spondylosis
1. Clinically, there are manifestations of spinal cord compression, which are divided into two types: central and peripheral. The symptoms of the central type start from the upper limbs, while the symptoms of the peripheral type start from the lower limbs first, and are divided into three degrees of mild, moderate and severe.
2.X-ray film shows that the posterior edge of the vertebral body mostly has osteophytes, and the sagittal path of the spinal canal appears narrow.
3, except for amyotrophic lateral sclerosis, spinal cord tumor, spinal cord injury, secondary adhesive arachnoiditis, and multiple peripheral neuritis.
4, individual differential diagnosis is difficult, can be made myelography examination.
5.CT scan can be performed if available.
Diagnosis of neurogenic cervical spondylosis
1.With more typical neurogenic symptoms, such as numbness and pain, and the scope is consistent with the area innervated by the cervical nerve.
2, Positive pressure neck test or upper limb pulling test.
3.X-ray film shows cervical curvature change, instability or bone formation.
4.No significant effect of pain point closure (this test may not be performed if the diagnosis is clear).
5.The clinical manifestations are consistent with the abnormalities seen on the X-ray film in the segment.
6.Except substantial lesions of cervical vertebrae (such as tuberculosis, tumor), thoracic supraspinatus syndrome, frozen shoulder, tennis elbow, biceps tenosynovitis and other disorders with pain in the upper limbs.