Cervical spondylosis is one of the common and prevalent diseases among middle-aged and elderly people. Cervical spondylosis is a general term for the clinical symptoms and signs manifested after cervical spinal lesions. Currently, the latest diagnostic criteria for cervical spondylosis are.
1, the diagnosis can be confirmed if the clinical manifestations are consistent with what is seen in the imaging.
2, with typical clinical manifestations of cervical spondylosis and normal imaging, attention should be paid to the diagnosis of cervical spondylosis only after excluding other patients.
3. If there is only abnormal imaging performance without clinical symptoms of cervical spondylosis, cervical spondylosis should not be diagnosed.
The diagnosis is based on the following respectively.
1.Cervical type.
(1) complaints of abnormal sensations such as head, neck and shoulder pain, accompanied by corresponding pressure points.
(2) The cervical spine shows manifestations such as curvature change or intervertebral joint instability on x-ray.
(3) Other disorders of the neck should be excluded (drop pillow, frozen shoulder, rheumatic myofibrositis, neurasthenia and other shoulder and neck pain not caused by degenerative disc degeneration).
2.Nerve root type.
(1) with more typical radicular symptoms (numbness, pain) and the scope is consistent with the area innervated by the cervical spinal nerve.
(2) Positive pressure head test or brachial plexus pull test.
(3) The imaging findings are compatible with the clinical presentation.
(4) No significant effect of painful point closure (this test may not be performed if the diagnosis is clear).
(5) Excluding the pain of the upper extremity caused by extra-cervical spine lesions (thoracic outlet syndrome, tennis elbow, carpal tunnel syndrome, elbow tunnel syndrome, frozen shoulder, biceps tenosynovitis, etc.).
3.Spinal cord type.
(1) Clinical manifestations of strong damage to the cervical spine.
(2) X-ray film shows osteophytes at the posterior edge of the vertebral body and spinal stenosis. The presence of spinal cord compression is confirmed by imaging.
(3) Excluding amyotrophic spinal cord sclerosis, spinal cord tumor, spinal cord injury, secondary adhesive arachnoiditis, and multiple peripheral neuritis.
4. Vertebral artery type.
The diagnosis of vertebral artery type cervical spondylosis is a problem that needs to be studied.
(1) There have been sudden collapse episodes. with cervical vertigo.
(2) Positive rotational neck test.
(3) Radiographs showing segmental instability or osteophytes of the pivotal joints.
(4) Mostly with sympathetic symptoms.
(5) Excluding ophthalmogenic and otogenic vertigo.
(6) Inadequate blood supply to the basilar artery due to compression of vertebral artery segment I (the segment of the vertebral artery before it enters the foramen cervicis) and vertebral artery segment III (the segment of the vertebral artery before it exits the cervical spine into the skull) are excluded.
(7) Vertebral arteriogram or digital subtraction vertebral arteriogram (DSA) is required before surgery.
5.Sympathetic nerve type
Clinical manifestations include dizziness, dizziness, tinnitus, hand numbness, tachycardia, precordial pain and a series of sympathetic symptoms. Negative vertebral arteriogram.
6.Other types
Difficulty in swallowing caused by compression of the esophagus by the anterior umbo-like growth of the cervical vertebrae (confirmed by barium examination of the esophagus), etc.