Cervical spondylosis is a general term for the clinical signs and symptoms 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) For those with typical clinical manifestations of cervical spondylosis and normal imaging, attention should be paid to the exclusion of other diseases before diagnosing cervical spondylosis.
(3) If there is only abnormal imaging but no clinical symptoms of cervical spondylosis, cervical spondylosis should not be diagnosed.
The diagnosis is based on the following
(1) Cervical type.
(1) Cervical type: (1) Complaints of abnormal sensations such as head, neck and shoulder pain, with corresponding pressure points.
(2) The cervical spine on X-ray shows changes in curvature or intervertebral joint instability and other manifestations.
(③Other 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 and pain), and the scope is consistent with the area innervated by the cervical spinal nerve.
(2) Positive head press test or brachial plexus pull test.
③The imaging findings are consistent with the clinical presentation.
④No significant effect of painful point closure (this test may not be performed if the diagnosis is clear).
⑤Excluding the disorders caused by extra-cervical spine lesions (thoracic outlet syndrome, tennis elbow, carpal tunnel syndrome, elbow tunnel syndrome, frozen shoulder, biceps tenosynovitis, etc.) with upper limb pain as the main cause.
(3) Spinal cord type.
(1) Clinical manifestations of strong damage to the cervical spine.
(2) Radiographs show osteophytes and spinal stenosis at the posterior edge of the vertebral body. The presence of spinal cord compression is confirmed by imaging.
(③Excluding 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 to be studied.
(1) There was a sudden collapse attack. With cervical vertigo.
(2) Positive rotational neck test.
③X-ray film shows segmental instability or osteophytes of the pivotal joint.
④More often accompanied by sympathetic symptoms.
⑤Except ophthalmogenic and otogenic vertigo.
(6) Exclude insufficiency of basilar artery supply caused by compression of vertebral artery segment I (the segment of vertebral artery before entering the transverse foramen of cervical 6) and vertebral artery segment III (the segment of vertebral artery before exiting the cervical spine into the skull).
(7) Vertebral arteriogram or digital subtraction vertebral arteriogram (DSA) is required before surgery.
(5) Sympathetic type: Clinical manifestations include a series of sympathetic symptoms such as dizziness, blurred vision, tinnitus, hand numbness, tachycardia, precordial pain, etc. There is instability or degeneration on x-ray. Negative vertebral arteriogram.
(6) Other types: cervical vertebrae with anterior bird’s beak-like hyperplasia compressing the esophagus causing dysphagia (confirmed by barium esophagogram), etc.