I. Definition: Cervical spondylosis is a clinical syndrome caused by degenerative degeneration of the cervical intervertebral disc and cervical spine osteophytes caused by neck injury, or disc prolapse, ligament thickening, deformation and narrowing of the cervical spinal canal or intervertebral foramen, stimulation and compression of the cervical spinal cord, nerve roots and blood vessels, resulting in a series of symptoms. The main manifestations are neck and shoulder pain, dizziness and headache, radiation to the head and occipital region or upper limbs, numbness of upper limbs, muscle atrophy, spasm of both lower limbs in severe cases, difficulty in walking, and even paralysis of all limbs, urinary and fecal disorders, and paralysis. Cervical spondylosis is one of the common and frequent diseases in middle and old people, with a higher incidence in men than in women. According to statistics, its incidence rises with age, while its incidence is gradually increasing and getting younger. The cervical type: ① complaints of head, neck and shoulder pain and other abnormal sensations with corresponding pressure points ② X-ray film of the cervical spine shows curvature changes or intervertebral joint instability and other manifestations ③ should exclude other cervical disorders (fallen pillow, frozen shoulder, rheumatic myofibrositis, neurasthenia and other non-degenerative disc degeneration caused by shoulder and neck pain neurogenic type: cervical degenerative disc changes or osteophyte stimulation, compression of the spinal nerve This causes sensory and motor dysfunction of the upper limbs, often manifesting as motor impairment or sensory numbness of one upper limb segment. Vertebral artery type: Due to the stimulation of degenerative changes of the hook vertebral joint, compression of the vertebral artery, resulting in inadequate blood supply to the vertebral basilar artery, often accompanied by dizziness, black haze and other symptoms, related to the rotation of the neck. Spinal cord type: cervical disc herniation, ligamentous hypertrophy and ossification or other causes of cervical spinal stenosis, spinal cord compression and ischemia, causing spinal cord conduction dysfunction. The main manifestations are unstable walking, numbness of the limbs, and difficulty in urination and defecation. Sympathetic nerve type: The stimulation of degenerative changes of cervical intervertebral discs, which compresses sympathetic nerve fibers in the neck and causes a series of reflex symptoms, is clinically rare, and is often mixed with cardiovascular diseases and endocrine diseases, making it difficult to distinguish. Mixed type: the onset of two or more fractions at the same time Second, the causes (1) bad posture: such as lying in bed watching TV, reading, like high pillow, long time low reading, work, sleeping in a moving car, sitting in the office staff for a long time to operate the computer, keep the head and neck in a single position for a long time, these bad posture will make the neck muscles in a long-term fatigue state, prone to injury. When sleeping, muscle protection is poor, and neck injury is easy to occur when braking. (2) head and neck trauma: head and neck trauma does not directly cause cervical spondylosis, but is often an aggravating factor for cervical spondylosis symptoms, some patients due to cervical spine osteophytes, cervical disc bulge, soft tissue lesions in the spinal canal caused by cervical spinal canal in a narrow critical state, plus cervical trauma often induced symptoms, and even paralysis occurs. Paralysis can also occur with inappropriate neck massage. Often, people already have varying degrees of pathology before trauma, putting the cervical spine at high risk, and trauma directly induces symptoms to occur. (3) Dysplasia or defects of the cervical spine structure: such as congenital spinal stenosis, congenital unilateral vertebral artery deficiency in patients, skull base depression, congenital fused spine, root canal stenosis, small spinal canal, etc. are all congenital developmental abnormalities, which are also important causes of this disease. (4) chronic strain injury: long-term local muscle, ligament, joint capsule injury can cause local hemorrhagic edema, inflammatory changes, and gradually inflammatory mechanization at the site of the lesion, and the formation of osteophytes, affecting the local nerves and blood vessels. Symptoms of the disease (1) Neck and shoulder pain can be radiated to the head and occipital region and upper limbs; (2) Heavy feeling on the back of one shoulder, weakness of upper limbs, numbness of fingers, loss of skin sensation of limbs, weakness of hand grip and sometimes unconscious grip to the ground. (3) The typical manifestations of severe cases are: weakness of the lower limbs, unstable walking, numbness of the two feet, and the feeling of stepping on cotton when walking. (4) In the most severe cases, there is even loss of control of bowel movements and urination, sexual dysfunction, and even tetraplegia. (5) It is often accompanied by head, neck, shoulder, back and arm pain, stiff neck and neck, and limited movement. (6) Some of them are accompanied by dizziness, house rotation, and in severe cases, nausea and vomiting, bedridden, and in a few cases, vertigo and sudden collapse. (7) When cervical spondylosis involves sympathetic nerve, dizziness, headache, blurred vision, swelling of the second eye, dryness, inability to open the second eye, tinnitus, ear blockage, loss of balance, tachycardia, panic, tight c feeling in the chest, and some even have symptoms such as gastrointestinal distention. There are also symptoms such as dysphagia and dysphonia. Most of the symptoms are mild at the onset and are not taken seriously, most of them can recover on their own, sometimes light and sometimes heavy, and only when the symptoms continue to worsen and cannot be reversed and affect work and life do they get attention. If the disease remains untreated for a long time, it will cause psychological damage and produce symptoms such as insomnia, irritability, anger, anxiety and depression. Fourth, auxiliary examination Cervical spine X-ray: often shows the loss of the normal physiological curvature of the cervical spine or reversion, narrowing of the intervertebral space, narrowing of the spinal canal, the formation of bone superfluous at the posterior edge of the vertebral body, and segmental instability of the cervical spine can also be observed in the hyperextension and hyperflexion of the cervical spine. CT of cervical spine: it can observe the hyperplastic calcification of cervical spine more clearly, respond to the degree of cervical disc protrusion, and have clear diagnostic value for spinal stenosis and vertebral body posterior edge bone superfluous formation. MRI of the cervical spine: it can clearly observe the herniated disc compressing the spinal cord Vertebrobasilar artery Doppler and angiography: it is used to detect the blood flow of the vertebral artery, and also to observe the travel of the vertebral artery, and has a higher value for the identification of patients with vertigo as the main symptom. Electromyography: It is suitable for patients with muscle weakness as the main manifestation, and the main purpose is to clarify the localization of the diseased nerve. V. Treatment Oral medication: mainly used for pain relief, local anti-inflammatory and muscle relaxation treatment, with clearer efficacy for local soft tissue strain secondary to cervical instability, etc., but cannot treat cervical spondylosis at the root. For patients with weakness or numbness of the limbs, neurotrophic drugs can also be used to assist rehabilitation and promote recovery of the compressed nerves. Traction method: to make the head and neck cervical spine curve incorrectly gradually changed, but its efficacy is limited, only suitable for patients with mild neurogenic cervical spondylosis; and traction is prohibited in the acute period to prevent local inflammation and edema aggravation; central type disc herniation is used with caution. Physiotherapy: physiotherapy is the abbreviation of physical therapy. It is the application of natural and artificial physical factors, such as sound, light, electricity, heat, magnetism and other effects on the human body to reduce inflammation and pain, improve blood circulation, to achieve the purpose of treatment and prevention of disease. Chinese medical methods: such as acupuncture, Chinese medicine, massage, cupping, gua sha, moxibustion, acupoint laser irradiation, buried wire therapy, etc. Surgery: For patients with a clear diagnosis of cervical spondylosis, serious symptoms of nerve root compression and no significant improvement in symptoms after conservative treatment, surgery should be adopted, while for patients with spinal cord type cervical spondylosis, i.e. patients whose main manifestation is walking weakness and unstable walking of both lower limbs, surgery should be implemented as early as possible to obtain a good recovery effect, because the treatment effect of such patients is closely related to the length of nerve compression. For patients with vertebral artery and sympathetic nerve excitation, the effect of surgery is relatively less certain.