Doctor, I have neck pain, is it “cervical spondylosis”? This kind of question appears N times a day in the clinic and now extends to the internet, forums, and postings, ……Is neck pain cervical spondylosis?
Answering this question is both simple and complex.
Say simple, because it is an understanding person will know, neck pain is not necessarily cervical spondylosis, may also be tired of playing computer games.
To say complex, because “cervical spondylosis” the connotation of this disease is both familiar and unfamiliar to everyone.
The general public literally understand, cervical spondylosis, cervical spine problems, of course, is cervical spondylosis. Is the problem really this simple? Of course not.
Cervical spondylosis, the English saying is “Cervical spondylosis”, the original meaning of English has “cervical joint stiffness” meaning.
Chinese surgeons held two “cervical spondylosis symposiums” in 1984 (Guilin) and 1992 (Qingdao), forming our own national “cervical spondylosis” concept of expression text, and the corresponding diagnostic criteria, these concepts and criteria have been used for more than 20 years, in the academic community has been agreed upon and For academic exchange has played a considerable role, therefore, medical experts have gradually forgotten the original literal meaning of “cervical spondylosis” and familiar with the name contains a set of syndromes, that is, orthopedic surgeons is absolutely impossible to “cervical spondylosis” understood as “cervical spine has a problem”.
Some scholars have disagreed with the name of “cervical spondylosis” and thought that the name literally has a broad meaning and cannot reflect the characteristics and main features of the disease in a straightforward manner, and the name of “cervical disc herniation” has been proposed in textbooks, causing certain ambiguity. However, with the passage of time, this voice has long been drowned out by history and become a passing cloud. This is the power of history and habit! Like & ldquo; polio & rdquo; known as & ldquo; infantile paralysis & rdquo; or & ldquo; polio & rdquo;, & ldquo; pediatric palsy & rdquo; the same, we all know that this designation is not rigorous and unscientific, but helpless has been called habitual, we all know what is referred to, and do not easily move again The new name of the cervical spondylosis is not a scientific name, but it has been called habitual, we all know what it refers to, and do not easily change, lest it cause new confusion.
Now let’s talk about the concept of cervical spondylosis.
Cervical spondylosis refers to degenerative changes in the intervertebral disc tissue of the cervical spine and its secondary degenerative (i.e. aging) changes in the intervertebral joints involving the surrounding important tissue structures (nerve roots, spinal cord, vertebral artery, sympathetic nerves, etc.), with corresponding clinical manifestations.
Cervical spondylosis contains three basic components.
1. degeneration of the cervical discs or degeneration of the intervertebral joints.
2, involvement of surrounding tissues.
3, the appearance of the corresponding clinical manifestations.
Translated, cervical spondylosis means that the cervical intervertebral disc degenerates (may also herniate) and the intervertebral joints degenerate (may also have osteophytes), thus stimulating or compressing the nerve roots, spinal cord, vertebral artery, and sympathetic nerves that were previously unharmed. These affected nerves and blood vessels were originally in their own way, but now they can’t do their own job — the corresponding clinical manifestations appear.
Diagnosis “cervical spondylosis” there are three conditions, the absence of one.
1, there are clinical manifestations of cervical spondylosis (including symptoms and signs) —— signs refer to the findings of the doctor’s examination
2, there is evidence of degeneration of the cervical spine, that is, imaging evidence (that is, X-rays show degeneration of the cervical spine or MRI shows a herniated disc)
3. The imaging examination and clinical manifestations are consistent, or to put it differently, the imaging findings can explain the clinical manifestations in terms of anatomy and pathology.
The following conditions are not cervical spondylosis.
1. Clinical manifestations of cervical disc degeneration (herniation) without corresponding nerve, spinal cord or vascular involvement only
2. There are similar manifestations of cervical spondylosis, but no evidence of cervical degeneration is found on imaging
3. If both of the above are present, but the two do not match, it can be assumed that the symptoms are due to other causes and not cervical spondylosis
You may also ask, what are the symptoms of cervical spondylosis?
Because cervical spondylosis may involve different surrounding tissues, the symptoms may vary greatly, and some may even be bizarre. According to clinical observation, cervical spondylosis is divided into the following types, namely cervical, radicular, spinal, vertebral artery, sympathetic and other types (at present, it mainly refers to the esophageal compression type).
The cervical type is dominated by symptoms in the neck, while the radicular type will show irritation and pain in the brachial plexus nerve, numbness and pain in the neck and shoulder area and upper limbs and hands, and in some cases, weakness. The spinal cord type may present with varying degrees of paralysis, unsteadiness in walking, weakness in the limbs, and urinary and fecal disorders. The symptoms of vertebral artery type and sympathetic type cross each other, and the symptoms are complex and varied, mainly headache, dizziness, tinnitus, panic, anxiety, non-sweating, dry eyes, etc., etc. Some scholars do not recognize the vertebral artery type and believe that it is all caused by sympathetic stimulation.
Of course, through the previous explanation about “cervical spondylosis”, we already know that these symptoms alone are not enough to be considered as cervical spondylosis.
I think these boring vocabulary has made everyone’s head big, did not read it does not matter, you should at least know that the diagnosis of cervical spondylosis actually has to have many, many strict conditions, and not casually can think who who is “ cervical spondylosis ”.
Who said you are “cervical spondylosis” you believe it? Professional doctors! Orthopedic or spine surgeon in a formal hospital. If someone without a professional background gives you a “cervical spondylosis” hat, you are advised to hold it and wait for us spinal surgeons to confirm it before you put it on, otherwise, throw it away!
Once to a doctor, he was working in front of the computer for 3 months straight because of his graduation thesis, neck pain. After seeing many hospitals in Shanghai, they all said it was cervical spondylosis and suggested he do surgery because MRI examination could see “cervical disc herniation”. Later I told him that it was not cervical spondylosis. Just cervical myofasciitis, or cervical strain, simply rest can be solved, first completely away from the computer.
There is a patient diagnosed with “spinal cord type cervical spondylosis”, a hospital recommended its surgery because of the symptoms of spinal cord compression, as well as MRI on the “cervical disc herniation”. I saw this patient when I went somewhere on a business trip, and found during the conversation that her speech was not very clear, asked her if she used to talk like this, and answered “no”. Then asked how about drinking water, answered “choke ”. I told her to see a neurologist and not to undergo surgery yet. The only reason I said she was not “cervical spondylosis” was that the imaging could explain her paralysis symptoms but not her throat symptoms. It was later proven to be a brainstem problem.
What is even more ridiculous is that there is a 12-year-old girl whose parents say they saw more than one “doctor”, all saying it was cervical spondylosis, I saw it, did not let her do any CT, MRI, the neck gently turned the symptoms disappeared, in fact, was tired of homework.
Now you can answer the question asked at the beginning, is neck pain cervical spondylosis?
A: It is possible that neck pain is cervical spondylosis, because most patients with cervical spondylosis have neck symptoms. But it definitely cannot be said that neck pain is cervical spondylosis.
The same question: Is a round red one an apple? Are all monks who can burn incense?
A: It is possible that the round red ones are apples, because most apples have this characteristic. But you can never say that a round red one is an apple! It is possible that those who can burn incense are monks, because monks can burn incense. But definitely can not say that will burn incense are monks, there may also be a panda ah!