Cervical spondylosis, commonly known as “cervical spondylolisthesis” and “cervical spur”, is a common bone and joint pathology, with the middle-aged and elderly being the most prevalent age group. According to its different clinical symptoms, modern medicine distinguishes different subtypes such as neurogenic, vertebral artery, crestal medullary and sympathetic nerve.
1.Clinical manifestations
Nerve root type: The main manifestations are pain and numbness in the neck, shoulder and upper limbs, occipital pain, weakened grip strength and muscle atrophy, which is caused by osteophytes making the intervertebral foramen smaller and thus compressing the nerve roots.
Vertebral artery type: The main symptoms are vertigo, headache, tinnitus, and hearing loss, which are often referred to as symptoms of insufficient blood supply to the brain.
Crista type: The main symptoms are weakness of the limbs, clumsy gait, trembling, etc. In severe cases, it can cause limb paralysis and urinary and fecal incontinence.
Sympathetic nerve type: The main symptoms are eye distension, blurred vision, migraine, cold limbs, tachycardia or bradycardia, excessive sweating or less sweating, etc.
2.Cause
This disease can occur due to both internal and external causes. The internal cause is due to the aging and thinning of the intervertebral disc, the hardening and protrusion of the fibrous ring, the narrowing of the intervertebral space, the relative decrease in the upper and lower diameter of the intervertebral foramen, the relaxation of the anterior and posterior longitudinal ligaments, and the increase in cone mobility with age. External factors are due to chronic strain of the cervical spine or long-term low head work and study, the cervical spine bends forward, the pressure in the upper and lower front half of the cone is greater than that in the back half, and the contact surface becomes smaller. Both of these factors can lead to reduced stability and vertebral injury, which are the basis for disc prolapse and formation of bone spurs.
3.Diagnosis and differentiation
The diagnosis of cervical spondylosis mainly relies on clinical manifestations and corresponding X-ray examinations. The main symptoms include pain and numbness in the neck, shoulder and upper limbs, dizziness, headache, tinnitus, earache, occipital pain, weakened grip strength and muscle atrophy. Coughing, head-pressure test or reverse pull test of upper limbs can aggravate the symptoms. CT and X-ray films can show changes in the physiological curvature of the neck, narrowing of the cervical space, osteophytes at the anterior, posterior and lateral edges of the cone, hyperplasia of the hook joint, and stenosis of the intervertebral foramen. Since the clinical manifestations of some diseases are very easy to be confused with cervical spondylosis, it is necessary to differentiate.
(1) Diseases that must be distinguished from neurogenic cervical spondylosis.
(1) Diseases that must be differentiated from neurogenic cervical spondylosis: angina pectoris: electrocardiogram is altered and can be relieved by nitroglycerin.
Rheumatism: there is often neck and shoulder pain and limitation of neck movement, and the application of adrenocorticotropic hormone has obvious effect, and there are changes in blood sedimentation and other corresponding laboratory tests.
Shoulder disorders: no positive X-ray signs of frozen shoulder and supraspinatus muscle inflammation.
(2) Diseases that must be differentiated from vertebral artery cervical spondylosis.
Arteriosclerosis: with a history of hypertension, vertebral arteriogram can be differentiated.
Ophthalmogenic vertigo: mostly caused by myopia, hyperopia, astigmatism, etc. The vertigo disappears when the eyes are closed.
(3) Diseases that must be distinguished from cremasteric cervical spondylosis.
Crestal medullary tumor: There may be pain or sensory disorder in the neck, shoulder, arm and hand, etc. X-ray plain film and cremasteromyelography can confirm the diagnosis.
Treatment methods
(1) Cervical spine traction state Chinese medicine ion introduction: cervical spine traction is mainly used for the treatment of acute attacks, which can enlarge the narrow intervertebral foramen and vertebral space, relieve the compression of nerve roots and surrounding tissues, and promote the elastic reset of compressed tissues. It is conducive to the effect of returning the protruding intervertebral disc to its original position. Chinese medicine ion introduction has obvious therapeutic effect on congestion, edema and muscle spasm of the diseased area. The combined treatment of the two can achieve twice the effect with half the effort.
(2) Tui Na, massage, acupuncture: their therapeutic purpose is to improve local blood flow and relieve muscle spasm in order to achieve the therapeutic purpose.
(3) Correction of poor posture: ambulatory workers and those who sleep on high pillows should correct cervical hyperflexion to prevent further aggravation of the condition.
(4) physical exercise: appropriate neck physical exercise can improve the strength of the neck muscles and promote local blood circulation, which can play the role of disease cure and disease prevention without disease.