I. Cervical spondylosis.
Cervical spondylosis is the corresponding symptoms and signs caused by degenerative lesions of the cervical disc and its secondary degenerative intervertebral joint lesions to the adjacent tissues (spinal cord, nerve roots, vertebral artery, sympathetic nerve, etc.) involvement.
Second, the cervical spondylosis is divided into five types.
Cervical spondylosis is divided into five types: nerve root type, spinal cord type, vertebral artery type, sympathetic nerve type, and esophageal compression type. And esophageal compression type is less common. Li Gang, Department of Rehabilitation Medicine, Qiqihar First Hospital
1. neurogenic cervical spondylosis: degenerative changes of the intervertebral disc protrudes to the lateral posterior, or the posterior vertebral body bone spur irritates and compresses the # spinal nerve root and causes sensory and motor dysfunction.
2. spinal cord type spondylosis: conduction dysfunction of the spinal cord caused by posterior protrusion of degenerative cervical discs or compression of the spinal cord by bone spurs at the posterior edge of the vertebral body.
3. sympathetic cervical spondylosis: a series of reflex symptoms caused by irritation or compression of sympathetic nerve fibers in the nerve roots, vertebral arteries and spinal cord membranes by cervical intervertebral discs or cervical spurs.
4. cervical artery type cervical spondylosis: Insufficient blood supply to the brain due to degenerative lesions of the hook vertebral joint, compression by bone spurs or compression of the vertebral artery by lateral protrusion of the intervertebral disc.
III. Treatment of cervical spondylosis.
1. most cervical spondylosis can be cured by conservative treatment, which includes: traction, physical therapy, medication and functional exercise; in addition, Chinese massage, acupuncture and moxibustion treatment are also very effective.
2. If conservative treatment is not effective, surgery can be used.
Conservative treatment for cervical spondylosis is actually rehabilitation treatment. And rehabilitation is a crucial part of the recovery process of function after surgery.
Fourth, conservative treatment rehabilitation program for cervical spondylosis.
1. Active period
Patients with heavy symptoms of cervical spondylosis in the active period can brake appropriately, such as wearing a neck brace and resting in bed, to reduce the load on the neck. At the same time, a professional doctor should decide whether traction should be used, together with physiotherapy and the use of appropriate medication to help relieve symptoms as soon as possible.
While receiving the above treatment, the following exercises should be performed to maintain muscle strength around the neck.
(1) Neck resistance isometric muscle strength exercises (
Hold for 10 seconds at the hardest point for 1 repetition, 10 reps/set, 2-3 sets/day.
It is best to practice in front of a mirror, making sure that the neck muscles are exerted during the exercise, but the head is not deflected in any direction and remains in a neutral position. This exercise mainly strengthens the muscles around the neck, improves neck control and cervical spine stability, and is very safe at the same time.
2. Recovery period.
After the acute phase, muscle strength exercises should be continued and strengthened to further improve the stability of the neck, to ensure the safety of the neck when gradually resuming activities of daily living, and to avoid recurrence as much as possible.
(1) “Bedside head lift” neck muscle exercises (
Hold for 10 seconds at the most forceful point for one repetition, 10 repetitions/set, 2-3 sets/day.
Make sure that the neck muscles exert themselves during the exercise, but the head does not deviate in any direction and remains in a neutral position. This exercise is designed to strengthen the muscles around the neck, improve neck control and cervical spine stability, and is very safe.
With the reduction of symptoms and the improvement of muscle strength, it can be gradually changed to power exercises.
Hold for 10-15 seconds where there is a pulling sensation or slight pain in the neck, 5 times/group, 1-2 sets of exercises in succession, 2 times in succession/day.
You must be guided by a medical professional before the exercise to know which direction activities can be done and which should be avoided as much as possible!
(3) Shoulder muscle exercises
Exercising the muscles of the shoulder usually passes through the neck as well, so it can help improve the strength and stability of the neck. It also corrects the muscle atrophy and muscle strength loss in the upper extremity caused by painful numbness in the acute phase.
Note: Along with functional exercises, attention must be paid to the protection of the cervical spine in daily life in order to consolidate the effects of the exercises and treatment and avoid relapse. For specific methods, please refer to the relevant chapters in Chapter 12 on guidance of daily life movements and postoperative rehabilitation care.
V. Postoperative rehabilitation program for cervical spondylosis.
Postoperative precautions for cervical spondylosis.
(1) Please listen carefully to the doctor or therapist’s explanation and read this plan before practicing. The new phase of exercises should be performed after review and permission from the doctor or therapist (in case of out-of-town patients, telephone consultation should also be conducted before starting the new phase of exercises) to ensure the safety of training.
(2) The methods and data provided in this plan are formulated in accordance with general conditions, and the specific implementation should be completed under the guidance of a doctor or therapist depending on your own conditions and injury, so as to know which items you do not need to practice and which items you cannot practice yet.
(3) The recovery of dysfunction caused by cervical spondylosis varies greatly due to individual differences and different conditions, so it is difficult to predict the recovery time and degree, so please be prepared to insist on practicing for a long time.
(4) Muscular strength exercises should be performed in groups with sufficient rest between groups. The number of exercises, time and load must be completed according to the requirements, and it is appropriate for the muscles to feel sore and fatigued, and to be relieved the next day, but there should be no pain or only slight pain. And do not increase the rest time in order to complete more times, otherwise it is difficult to achieve the desired effect.
(5) Muscle exercises should pay attention to even breathing, do not hold your breath.
(6) All exercises should be performed on the left and right side separately, but the intensity of both sides may not be the same, one side of the state is not as good as the other side, do not force to complete the action in order to achieve the same training intensity, so as not to cause tissue damage.
(7) The functional exercises should be made daily and habitual, and the movements that can be done independently should be done independently as much as possible in life to minimize the dependence on others, otherwise it will affect the process of functional recovery.
(8) Pay attention to the safety of sitting up and turning and other movements.
1. 0-2 weeks after surgery
Cervical brace is generally required for protection after cervical spine surgery.
0-3 days after surgery.
(1) Wrist joint movement exercises.
Place the arm flat on the bed, with the hand hanging out of the bed surface, palm down. Open your hand and raise your wrist at the same time; make a fist and bring your wrist down at the same time; put your five fingers together and deviate to the left and right at the same time. Slowly push to the limit, hold for 10 seconds, and then slowly relax, rest for 5 seconds between times, 15-20 times/group, 2-4 groups/day.
(2) Ankle pump).
Repeated flexion and extension of the ankle joint with force, slowly and in full range, 5 minutes/group, 1~2 groups/hour.
(3) Lower limb muscle strength exercises: the amount of exercises is based on fatigue, 2 times/day.
3 days after surgery.
(1) Continue and strengthen the above exercises.
(2) Bedside sitting exercises.
With the doctor’s permission, wear a peri-collar and use the correct turning and sitting up movements to perform the exercises. Note that early exercises are prone to postural hypotension; if it occurs, just lie flat on your back immediately.
(3) Standing exercises: Patients who have continued bedside sitting exercises for more than 30 minutes can start the exercises.
Standing weight-bearing and balancing exercises.
2 minutes/repetition. Rest 5-10 seconds, 5 times/group. 2-3 groups/day
(4) Gradually increase the intensity and activity of the exercises.
2. 2 weeks to 3 months after surgery
(1) Cervical resistance isometric exercises ().
Hold at the most forceful point for 10 seconds for 1 time, 10 times/group, 2-3 groups/day.
It is best to practice in front of a mirror, making sure that the neck muscles are exerted during the exercise, but the head is not tilted in any direction and remains in a neutral position. This exercise mainly strengthens the muscles around the neck, improves neck control and cervical spine stability, and is very safe at the same time.
(2) Neck mobility exercises.
Note: Before practicing neck mobility, it is important to check with your surgeon about the type of surgery you are having and decide when to start neck mobility exercises to avoid delays or accidents. In general, practice should begin 2 weeks postoperatively for patients undergoing simple posterior surgery with the anchoring method and for patients undergoing artificial disc replacement, and 6 weeks postoperatively for patients undergoing posterior surgery with the capsular suspension method and for patients undergoing fusion.
Hold the exercise for 10-15 seconds at the neck with a pulling sensation or slight pain, 5 times/group, 1-2 sets of exercises in succession, 2 times in succession/day.
It is important to be guided by a professional doctor before the exercise to know which direction activities can be done and which should be avoided as much as possible!
(3) Shoulder muscle exercises).
Exercising the muscles of the shoulder usually passes through the neck as well, so it can help improve the strength and stability of the neck. At the same time to correct the acute pain and numbness caused by muscle atrophy and muscle strength loss in the upper limbs.
(4) Abdominal supine leg raises.
Hold until exhaustion for one time. Interval 5 seconds, 15-10 times / group, 2-3 groups / day.
(5) “Air” bicycle exercises.
20-30 reps/group with 20 seconds interval. 3-5 groups in a row, 2-3 reps in a row/day.
(6) “Flying Swallow” exercise.
Hold until exhaustion for 1 time, 5-10 times / group, 2-3 groups / day.
(7) Flexion of the leg supine.
Hold for 10-30 seconds/repeat with 5 seconds interval. 5-10 reps/set. 2-3 sets/day.
3. 3 months to 12 months after surgery
(1) “Bedside head lift” neck muscle exercises.
Hold at the most forceful point for 10 seconds for 1 time, 10 times/set, 2-3 sets/day.
Make sure that the neck muscles exert themselves during the exercise, but the head does not deviate in any direction and remains in a neutral position. This exercise is designed to strengthen the muscles around the neck, improve neck control and cervical spine stability, and is very safe.
With the reduction of symptoms and the improvement of muscle strength can be gradually changed to power exercises.
(2) Swimming (preferably in backstroke position), tai chi, walking, mountain climbing, etc. Avoid intense confrontational programs.
Note: In addition to functional exercises, attention must be paid to the protection of the cervical spine in daily life in order to consolidate the effects of exercises and treatment and avoid recurrence. For specific methods, refer to the relevant chapters in Chapter 12, Daily Life Movement Guidance and Postoperative Rehabilitation Care.