The greatest challenge for human health in the 21st century is to improve the quality of life, and health will become the most important prerequisite for people to enjoy life. The spine is called the “second lifeline of the human body”. Medical research shows that the life expectancy of a person should be more than 120 years old, and spinal problems can shorten the life expectancy of a person by 1/3. Therefore, spinal disease has become a human health problem that cannot be ignored.
Spinal disease manifests itself in various forms, of which cervical spondylosis is the most common. According to statistics, the incidence of cervical spondylosis in China has been increasing in recent years, and its incidence increases exponentially with the growth of different age groups. The survey shows that about 7-10% of people in the country suffer from cervical spondylosis, and some scholars in a survey of 2,000 samples, the incidence rate reached 12%. 50-60 years old cervical spondylosis prevalence rate increased exponentially, about 20%-30%, 60-70 years old In 2002, the “Report on the Current Situation of Cervical Spine Development in China’s Youth” showed that more than 80% of youths in China have cervical spine in a subhealthy state. A hospital in Tianjin investigated 2,000 patients with cervical spondylosis, and found that adolescent patients accounted for 12% of them, and 87% of them were accompanied by cerebrovascular spasm. Among these adolescent patients, the youngest was only 9 years old, and one child developed cervical osteophytes at the age of 12, while the majority of patients were concentrated in the age groups of 12-13 and 16-18.
Abnormal cervical spine X-ray (physiological curvature straightening)
I. Main factors affecting the health of the cervical spine in adolescents
1.Chronic strain injury
Chronic strain injury is one of the most important factors affecting the cervical spine health of adolescents. Adolescents are at a critical stage of physical development, and many poor living and learning habits, such as prolonged reading and writing due to academic tension; prolonged playing games and surfing the Internet; watching TV in bed, sleeping with too high a pillow at night. These factors can make the neck muscles in a state of tension for a long time, resulting in strain injury caused by overloading the neck muscles and ligament tissues.
2.Acute injury
Acute injury history is another factor that affects the cervical spine health of teenagers. Most adolescents like sports, and in various sports adolescents lack the awareness and knowledge of self-protection. In the participation of recreational sports activities, sudden turn of the neck or external violence injury can fall is cervical instability, tissue damage and produce varying degrees of neck pain, and many adolescents do not pay attention to the injury, continue to carry out strenuous activities or uncoordinated neck movement, not timely or irregular neck pushing and rotating movements and aggravate the condition.
3.Environmental wind, cold and damp stimulation
External factors such as cold and humidity are important factors for cervical disc degeneration. Adolescents sleep cool in summer, the back of the neck for a long time blowing air conditioning or electric fans, over time these wind cold wet stimulation can cause the neck muscle blood circulation slowed, inflammatory factors exuded, inducing local aseptic inflammation, resulting in neck pain stiffness, heavy shoulders and other abnormal feelings, inducing cervical spondylosis.
4.Infection in the throat
Once the throat is inflamed, pathogenic substances such as bacteria and viruses can spread along the lymphatic channels to the muscles and ligaments in and around the neck joints, causing these tissues to spasm, contract and degenerate, resulting in a decrease in muscle tone. As the ligaments, joints and bones of adolescents are not yet well developed, inflammation of the throat can cause local vascular congestion and edema, resulting in relaxation of the ligaments near the cervical vertebrae, which can easily cause the first and second cervical vertebrae to be dislocated or subluxed. This is manifested as restricted neck movement and a special oblique neck deformity, in which the head is tilted to one side and mildly bent, and the posture is like a person listening carefully to others, producing cervical spondylosis.
5.Psychological factors
Because of the long course of cervical spondylosis, it is easy to recur and the condition is light and heavy at times, which can cause emotions such as tension, anxiety and fear in adolescents. It is clinically found that bad mood will make cervical spondylosis aggravate, and the aggravation or relapse of the disease will make the mood even worse, thus forming a vicious circle. Some studies show that long-term suppressed feelings and sentimentality not only lead to neurasthenia in adolescents, but also affect the rest of bones, joints, muscles and other tissues and organs, and adolescents are prone to these conditions due to academic pressure and the special stage of physical and psychological development, so psychological factors become another important factor in triggering and aggravating cervical spine disease in adolescents.
Second, the common signs of cervical spine damage in adolescents
Once adolescents suffer from cervical spondylosis, they will feel shoulder and neck pain, tugging sensation, headache, vertigo, upper limb numbness, and in serious cases, they will hear local bone rubbing sound, which will seriously affect the learning and physical development of adolescents. Common signs of cervical spine damage in adolescents are as follows.
1, pain: pain is the most common and easily detected clinical manifestation, including simple neck pain, pain in the occipital region, the back of the head or shoulders, and pain that increases when the head and neck are moved; discharge pain, neck and shoulder pain with discharge pain in one or both upper limbs, etc.
2.Numbness: It starts with slight numbness and a slight ant crawling sensation on the skin of the fingers and back of the hand, and as the condition continues to worsen, dullness of skin sensation may appear.
3.Muscle spasm: Initially, it is manifested as a feeling of neck discomfort in the morning, mainly pain; in severe cases, the neck, shoulder and back muscles are tense and spasm occurs, so that the neck is maintained in a posture and does not dare to move.
4. Headache and dizziness: They are also common symptoms, mostly manifested as pain in the forehead, top and occipital area, mostly without specificity. There may be movement disorder and muscle atrophy when gradually aggravated.
Third, the correct understanding of our cervical spine
Understanding the characteristics of the anatomical structure of the cervical spine is very important for us to better understand the occurrence of cervical spondylosis. So what are the characteristics of the anatomical structure of the cervical spine? Here I will give you some detailed knowledge of the anatomical structure of the cervical spine.
First of all, I would like to introduce you to the anatomical structure of the cervical vertebrae: there are 7 vertebrae in the human cervical spine, except for the first and second cervical vertebrae which are special cervical vertebrae due to their shape, the other 5 cervical vertebrae are basically similar in shape and are called common cervical vertebrae. Each vertebra of the ordinary cervical vertebra consists of three parts: vertebral body, vertebral arch and protrusion.
Vertebral body: from the second cervical vertebra to the sixth cervical vertebral body gradually increases, the transverse diameter of the vertebral body is about two times the sagittal diameter, and the top is slightly smaller than the bottom. The posterior edge is slightly higher than the anterior edge. The average sagittal diameter on the dry bone is 1 mm, and the transverse diameter is 24 mm, slightly larger in men than in women. The upper part of the vertebral body is concave on the transverse diameter. In the sagittal diameter convex; vertebral body below in the transverse diameter convex and concave in the sagittal diameter. The anterior edge of the vertebral body above is sloped, and the anterior edge below has a dragon like protrusion that covers the slope of the upper edge of the next pushing body, and the upper and lower vertebral bodies overlap in a saddle shape, so that the intervertebral space seen in front of the vertebral body is lower than the intervertebral space in the middle of the vertebral body. The front of the vertebral body is curved and elevated, and its upper and lower edges are attached by the anterior longitudinal ligament. The posterior surface is flattened and has a trophoblastic vascular access hole. The posterior longitudinal ligament is attached to this. The lateral side of the vertebral body has a crest-like elevation above the vertebral body, called the leptomeninges, and the obtuse surface of the corresponding slope below the superior vertebral body forms the leptomeningeal joint, also known as the luschka joint. This joint is a synovial joint with cartilage covering the surface and surrounded by a joint capsule. It is involved in the movement of the cervical spine and restricts the lateral movement of the vertebral body. It can increase the stability of the intervertebral body; degenerative changes occur with age. It can compress blood vessels and nerves and cause corresponding clinical symptoms
The vertebral arch: emanates from the lateral posterior side of the vertebral body and is bow-shaped. It is composed of two sides of the arch and a pair of vertebral plates. The vertebral arch is short and thin, and is connected to the posterior outer edge of the vertebral body at an angle of 45°, with a narrower depression on the upper and lower edges, which is called the upper and lower notch of the cervical vertebrae. The two adjacent vertebrae are circled by the upper and lower notches to form the intervertebral foramen, between which the spinal nerve and accompanying blood vessels pass. The vertebral plate is the posterior extension of the vertebral arch, plate shaped, narrow, long and thin, and forms the vertebral canal at the posterior edge of the vertebral body with the vertebral arch on both sides. The upper vertebral plate downward edge of the backward, there is a tendency to cover the lower vertebral plate, the front of the yellow ligament attached, and extended downward to stop at the upper edge of the lower vertebral plate. When it is thickened or relaxed, it can protrude into the spinal canal and compress the spinal cord, especially when the cervical spine is posteriorly extended.
The intervertebral disc: the intervertebral disc is divided into the central part of the nucleus pulposus, a gelatinous material rich in elasticity; the peripheral part of the fibrous ring, arranged in concentric circles by multiple layers of fibrocartilage rings. In the cervical and lumbar regions, the annulus fibrosus is thick in the front and thin in the back, and the nucleus pulposus tends to protrude posteriorly into the spinal canal or intervertebral foramen, compressing the spinal cord or spinal nerve.
The intervertebral disc is located between the two vertebral bodies of the human spine and is a sealed body composed of cartilage plate, fibrous ring, and nucleus pulposus. There are cartilage plates above and below, which are transparent cartilage covering the vertebral body, and a bone surface in the middle of the epiphyseal ring below. The upper and lower cartilage plates together with the fibrous ring seal the nucleus pulposus. The fibrous ring consists of collagenous fibrous bundles of fibrocartilage that are located around the nucleus pulposus.
The fiber bundles of the fibrous ring cross and overlap each other obliquely, making the ring a solid tissue that can withstand large bending and torsional loads. The anterior side and sides of the fiber ring are thicker, while the posterior side is thinner. The anterior part of the fiber ring has a strong anterior longitudinal ligament, while the posterior side has a narrower and thinner posterior longitudinal ligament. As a result, the nucleus pulposus tends to protrude posteriorly and compress the nerve roots or spinal cord. It is known that the use of pure natural sawtooth shark cartilage powder can strengthen and consolidate the fibrous ring.
The nucleus pulposus is an elastic, gelatinous substance that is encapsulated by the fibrous ring and cartilage plates. The nucleus pulposus contains mucopolysaccharide protein complex, chondroitin sulfate and a large amount of water, with a water content of 90% at birth and about 80% in adulthood. The main change is the dehydration of the nucleus pulposus, and the disc loses its normal elasticity and tension after dehydration. On this basis, the nucleus pulposus protrudes from the nerve root due to prolonged strain, heavy trauma or repeated inconspicuous injuries, resulting in weakness or rupture of the annulus fibrosus, which produces signs of nerve root injury.
Special anatomical structures of the cervical spine.
①Atlantoaxial spine: irregularly shaped, consisting of a pair of lateral blocks, a pair of transverse processes, and two arches, anterior and posterior, which are connected to the skull and jointed with the cardinal spine. The anterior and posterior arches are thin, especially at the resounding with the lateral blocks, which are susceptible to violence resulting in fracture and dislocation there.
② pivot vertebrae: is because there is a section of the vertebral body above the columnar protrusion called “dentition”, and the dentition has the role of pivot and was named. The dentition is more likely to be absent during development. The root of the dentary process is thin and is prone to fracture in case of trauma, leading to paraplegia, which can be life-threatening.
(iii) Hooked protrusions: the ridged protrusions on both sides of the upper circumference of the vertebral body that are posteriorly oriented are called hooked protrusions. The barbels are mostly oval in shape, with the oblique muscle in front, the transverse foramen on the outside, the posterior lateral involvement in forming the anterior arm of the intervertebral foramen, and the intervertebral disc on the inside, all near which are important blood vessels and nerves in the neck, so the barbels structure has important anatomical significance in the cervical spine.
④ Hook vertebral joint: the hooked protrusions team up with the lateral slope of the lower edge of the adjacent upper vertebral body to form the hook vertebral joint, one on each side, which is unique to the cervical spine. This joint prevents the disc from protruding laterally and posteriorly. Since this joint is located at the edge of the intervertebral space, when the cervical spine is rotated and other movements are made, the local mobility is greater, the hook-like protrusions on both sides are inclined, the local vertebral space is narrower, and the pressure and shear force generated by the activities of the cervical spine are often concentrated here, so degenerative changes can occur earlier. In the case of degenerative disc degeneration, this protrusion is impacted and deformed into a hardened bone spur, and the proliferating bone spur may compress the nerve root in the posterior intervertebral foramen or affect the blood circulation of the vertebral artery located laterally, resulting in symptoms of pain, numbness or vertigo in the upper extremity.
⑤ Transverse foramen: the transverse process of the cervical spine has two nodes in the front and back, which surround each other to form the transverse foramen, and this structure is unique to the cervical spine. Except for the transverse foramen of the seventh cervical vertebra, which is small, all of them have the vertebral artery passing through. When the neck moves, especially when the cervical spine is unstable, the internal structure of the transverse foramen is easily stretched and squeezed. When lesions such as osteophytes occur in the cervical spine, this can lead to changes in the mechanics of vertebral artery blood flow, affecting the blood supply to the brain and producing symptoms of cervical spondylosis such as vertigo and nausea.
From the above anatomical features of the cervical spine, we can easily see that although the cervical spine is the smallest in size among the spinal vertebrae, its structure is more complex and prone to strain and trauma during frequent activities, leading to cervical spondylosis and other disorders.