I. Treatment methods of cervical spondylosis
At present, there are many methods of treating cervical spondylosis at home and abroad, which can be divided into two categories: non-surgical therapy and surgery. China mostly adopts a variety of methods combining Chinese and Western medicine to treat cervical spondylosis. Most patients can obtain better results through non-surgical treatment, and it is popular because it costs less and is less painful. Only in a very small number of cases, the symptoms of nerve, blood vessel and spinal cord compression are progressively aggravated or recurrent, seriously affecting work and life, and then surgery is required.
Non-surgical treatment includes manipulation, Chinese and Western medicine, cervical collar, cervical pillow, cervical traction, local closure, physiotherapy, acupuncture and functional exercise, etc.; surgical treatment includes posterior laminectomy and decompression, anterior discectomy, intervertebral implantation, bone spur resection, vertebral artery decompression, etc. When treating, the appropriate method should be selected according to the patient’s condition.
Second, non-surgical treatment of cervical spondylosis
Non-surgical therapy is also called integrated therapy of Chinese and Western medicine. It is the most basic therapy for cervical spondylosis. It includes cervical spine traction, physical therapy, massage, acupuncture, medicine, collar, 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 treatment can lay a good foundation for surgical treatment.
This is because cervical spondylosis is accelerated by various additional factors on top of the degeneration of the body. Therefore, in order to stop, 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, thus, non-surgical therapy is the basic therapy for this disease.
Indications for non-surgical treatment
(a) Cervical disc herniation;
(2) Nerve root type, sympathetic nerve type and vertebral artery type cervical spondylosis;
(3) Early spinal cord type cervical spondylosis;
(iv) Elderly, frail or with poor cardiac, hepatic or renal function, unable to tolerate surgery;
(v) Severe neurological disorders or mental disorders with cervical spondylosis;
(vi) The diagnosis of cervical spondylosis is not completely certain and needs to be observed during the treatment;
(vii) Patients who are recovering from surgery.
IV. Cervical traction therapy
Cervical spine traction therapy is a more effective and widely used treatment method for cervical spondylosis. This therapy is applicable to all types of cervical spondylosis and is more effective for early cases. Cervical traction for spinal cord type cervical spondylosis with a long period of illness can sometimes aggravate the symptoms, so it is less often used. The mechanisms of action of cervical traction are.
(a) Restrict the movement of the cervical spine, which is conducive to tissue congestion and the decreasing of edema.
(b) Release the muscle spasm of the neck, thus reducing the pressure on the intervertebral disc.
(iii) enlarge the intervertebral space and intervertebral foramen, so that the irritation and compression of the nerve roots can be eased and the adhesions between the nerve roots and the surrounding tissues may be loosened.
(d) Cushion the pressure of the disc tissue towards the periphery and help to reduce the swelling of the already outwardly protruding annulus fibrosus.
(v) To allow extension of the vertebral artery that is twisted between the transverse foramina.
(vi) Traction on the embedded synovial membrane of the small joint.
Traction method: Usually the occipito-mandibular band traction method is used. In mild cases, intermittent traction is used, 1~3 times a day, 1/2~1 hour each time; in severe cases, continuous traction is feasible, 6~8 hours a day. The traction weight can start from 3~4 kg, and the traction weight and traction time can be increased appropriately according to the age, physical strength, neck muscle development and the patient’s response to traction treatment.
Course of treatment: 30 times of traction with small weight is a course of treatment. If it is effective, traction can be continued for 1~2 sessions or longer. Rest 7~10 days between treatments. In the traction treatment, if you can cooperate with other treatment measures, can improve the efficacy.
V. Physiotherapy for cervical spondylosis
The role of physiotherapy: in the treatment of cervical spondylosis, physiotherapy can play a variety of roles, and is also a more effective and commonly used treatment method. Its mechanism of action is.
1, eliminate the nerve roots and surrounding soft tissue for inflammatory edema.
2, improve the blood supply and nutritional status of the spinal cord, nerve roots and neck.
3.Ease the muscle spasm of the neck, enhance the effect of cervical traction, and improve the blood circulation of the soft tissues of the neck.
4.Delay or reduce the process of calcification and ossification of intervertebral joints, joint capsule and ligaments.
5.Enhance muscle tone and improve the function of small joints.
6.Improve the systemic calcium and phosphorus metabolism and the function of the vegetative nervous system.
The methods are.
1, ion introduction therapy: the application of direct current to import a variety of Chinese and Western drugs (procaine hydrochloride, potassium iodide, Chen vinegar, glacial acetic acid, Wellbutrin, etc.) for the treatment of cervical spondylosis, with certain therapeutic effects.
2.High frequency electrotherapy: commonly used are ultra-short wave, short wave and microwave therapy, through its deep electrothermal effect, improve the blood circulation of the spinal cord, nerve roots, vertebral artery and other tissues to facilitate the recovery of their functions.
3.Paraffin wax therapy: using heated paraffin wax applied to the affected area, after the tissue is heated, the local blood vessels expand, circulation is accelerated, cell permeability increases, which is conducive to the dissipation of tissue edema and absorption of hematoma.
4.Other: such as glacial acetic acid, other Chinese medicine import, electric excitation therapy machine, etc., have certain effect in reducing the symptoms of cervical spondylosis.
Six, cervical spondylosis massage, massage therapy
Massage and massage therapy is a more effective treatment measure for cervical spondylosis. Its therapeutic effects on cervical spondylosis are.
1, dredge the veins and channels, stop pain and numbness.
2, widen the vertebral space, expand the intervertebral foramen, rectify the slipped vertebral body, and release the nerve compression.
3.Relax nerve roots and soft tissue adhesions to relieve symptoms.
4.Ease muscle tension and restore cervical spine activities.
5.Massage on paralyzed limbs can reduce muscle atrophy and prevent joint stiffness and joint deformity.
Broadly divided into two categories.
1, the traditional massage, massage techniques;
2, rotational repositioning techniques: applied to cervical small joint disorders, cervical subluxation and other disorders, clinical cases found to have spinal eminence skewed, X-ray film with double convex, double concave, bilateral and other spinal rotation performance.
The doctor stands behind the patient and holds the intersection of the “T”-shaped percussion hammer with a rubber tip in the left hand, with the hammer handle to the left rear and one end of the hammer placed obliquely on the right side of the affected cervical spinous process with the tip pointing to the right front. The doctor holds the other end of the hammer with his thumb, makes the patient flex his neck and lean backward against the doctor’s chest and abdomen, relaxes the neck muscles, places the palm of the doctor’s right hand on the left side of the patient’s jaw angle and rotates his head to the left side with force, while using the force of the left thumb and body to push the hammer to the left side of the affected cervical spine.
In the process of rotation, a crisp sound can be heard, and then the distortion of the spinous process disappears, indicating that the distortion of the spinous process has been corrected and the patient feels that the symptoms have improved. After the rotation, press and rub the neck muscles on both sides, and point and rub the Fengchi points on both sides. If the skewed spinous process has been corrected and the patient still has some symptoms, passive rotation of the head and neck and flexion of the neck on both sides can be added, and further improvement of symptoms can often be obtained.
VII. Drug treatment of cervical spondylosis
Drugs can play an auxiliary symptomatic treatment role in the treatment of cervical spondylosis, and the commonly used drugs are.
(a) antipyretic and analgesic agents: aspirin, anti-inflammatory pain, inflammatory pain, prednisone, anti-inflammatory spirit, etc. can be taken orally for severe pain.
(ii) vasodilator drugs: such as nicotinic acid, vasopressin, dibazol, etc., can dilate blood vessels and improve the blood supply to the spinal cord.
(iii) antispasmodic drugs: such as antantric tablets, phenytoin sodium, etc., which can release muscle spasm and are suitable for those with increased muscle tone and severe clonus.
(iv) Drugs for nutrition and regulation of the nervous system: commonly used are glutathione, spikenard candy-coated tablets, brain-boosting combination, Zhu Sha An Shen Wan and Bai Zi Yang Xin Wan, which can regulate the function of the nervous system. Vitamin B1, vitamin B12, etc. help the recovery of neurodegeneration.
Eight, the local application of drugs for cervical spondylosis
1.Water acupuncture therapy: “Water acupuncture” refers to the injection of a certain drug into acupuncture points or painful points, which is a symptomatic treatment measure to eliminate pain, numbness, dizziness, insomnia and other symptoms with good effect, often used in conjunction with other treatment methods. Commonly used drugs are: 0.25~1% procaine hydrochloride plus prednisolone suspension, vitamin B1, vitamin B12, 5% glucose injection, 50~100% salvia injection, 50% dogbane injection, etc.
Among them, vitamin B1 and vitamin B12 are applied to patients with numbness as the main symptom, while Salvia injection has good effect on patients suffering from pain and plant nervous system dysfunction.
2. Topical pain relieving application: The topical application of this kind of drugs has good effect on reducing pain caused by myofasciitis and muscle strain. The commercially available medicines include turpentine and wintergreen oil ointment and orthopedic water. When applied, the affected area will be washed and first hot compress, and then rub the affected area with fingers dipped in a little liquid or ointment, with pain relief, numbness and relaxation.
3, external medicine and fumigation medicine: this method also has a certain effect on the elimination of muscle aches and pains. Commercially available medicines are Kanli sand.
Nine, cervical spondylosis of Chinese medicine treatment
According to the dialectical treatment, Chinese medicine mostly adopts the method of dispersing wind and dispelling dampness, activating blood circulation, relieving tendons and pain, which is effective in reducing pain, numbness, dizziness and other symptoms. Commonly used Chinese medicines include: papaya pill, rheumatism paralysis pain tablet, bone replacement dan, blood and tendon pill, tung pill, cervical rejuvenation granules, etc.
X. Collar and neck brace
The collar and neck brace can protect the cervical spine by braking, reduce the wear and tear of the nerves, reduce the traumatic reaction of the intervertebral joints, and help the tissue edema to subside and consolidate the healing effect to prevent recurrence.
The collar and cervical brace can be applied to patients with all types of cervical spondylosis, and are more suitable for patients with acute attacks, especially for patients with cervical disc herniation, sympathetic and vertebral artery cervical spondylosis. The collar is widely used because it is simple to make, using ordinary cardboard cut into a band according to the height and circumference of the neck, the outside of which is covered with knitted items, and the two ends can be made into a cloth belt according to the assembly. It is worn during the day and can be removed when resting. The neck brace is more complicated to make. It is less commonly used by patients with cervical spondylosis.
Long-term application of neck brace and collar can cause muscle atrophy of the neck and back, stiff joints, but not beneficial, but harmful, so the wearing time should not be too long, and in the application of the period to often carry out medical physical exercise. After the symptoms are gradually reduced, the collar and neck brace should be removed in time to strengthen the muscle exercise.
Eleven, medical sports
The muscles of the whole body of patients with various types of cervical spondylosis can be significantly atrophied due to neurotrophic disorders or disuse, and cause symptoms such as muscle strain and myofascial class. The joint capsule, ligaments, muscles and other tissues around the cervical spine may also become adherent and appear stiff due to inflammatory reactions and lack of activity, etc. Therefore, patients should be encouraged to actively engage in medical sports.
The effects of medical sports on cervical spondylosis are.
(a) Improving the function of the intervertebral joints of the cervical spine.
(ii) Enhancing the tension of muscles, ligaments, joint capsule and other tissues, and strengthening the stability of the cervical spine.
(iii) Improving the blood of the cervical spine.
(iv) Correction of poor body posture.
Long-term medical physical exercise helps to improve the symptoms of cervical spondylosis, consolidate the therapeutic effect and reduce recurrence for a long time. Therefore, medical sports play an important role in the prevention and treatment of cervical spondylosis.
The method of medical sports varies from person to person, with cervical and back muscle strain as the main symptom, to exercise the neck and back muscles; upper limb muscle atrophy and weakness, to exercise the upper limb movements; and lower limb limp weakness, walking difficulties, to practice walking and squatting movements; tetraplegia patients, the loss of the ability to move independently, in addition to strengthening care to prevent various complications, the muscles of the paralyzed limbs to In addition to strengthening care and preventing various complications, the muscles of the paralyzed limbs should be massaged and the full range of passive movement of all joints should be carried out two or three times a day to reduce muscle atrophy and prevent joint stiffness and joint deformity.
Twelve, magnetic therapy
Meridian magnetic field therapy is a method of treating certain diseases by using magnetic field as a kind of stimulation energy for meridian acupuncture points. The treatment of cervical spondylosis with muscle strain, myofasciitis and a few cases of cervical spondylosis with more pronounced pain of nerve root type does have certain effect in reducing pain. The magnetic materials used are: cerium-cobalt-copper-iron alloy or samarium-cobalt alloy, etc. The treatment method can be applied directly to the affected area or acupuncture point, or the magnetic therapy machine can be applied.