With the rapid development of science and technology, the products of modern civilization, such as computers, the Internet and automobiles, are quietly damaging our bodies, especially the health of the cervical spine, while improving people’s standard of living. In recent years, cervical spondylosis has exceeded lumbar disc herniation, becoming the highest incidence of degenerative diseases of the spine. Among them, the “white-collar” class is the best population of cervical spondylosis.
1.What can cause cervical spondylosis?
Cervical spondylosis refers to the degenerative changes of the cervical intervertebral disc and secondary pathological changes, involving the nerve roots, spinal cord, vertebral artery, sympathetic nerve and other surrounding tissue structures to appear the corresponding clinical manifestations.
Degenerative changes in the cervical intervertebral disc with age are the pathological basis of cervical spondylosis. Long-term ambulation, driving, cold in the neck, poor sleep posture, neck trauma, inflammation of the throat and other factors can induce cervical spondylosis.
2.What is the pathological mechanism of neurogenic cervical spondylosis? What are the clinical manifestations?
The neurogenic type is the most common type of cervical spondylosis. Both the hook vertebral joint and synovial joint hyperplasia can cause intervertebral foraminal narrowing and nerve root compression, resulting in nerve root irritation symptoms. The symptoms are pain in the neck and shoulder, soreness in the upper arm, forearm and fingers; in severe cases, cut-like pain, numbness, sensory impairment, reduced muscle strength and muscle atrophy.
3.What are the characteristics of Chinese medicine in treating neurogenic cervical spondylosis?
For neurogenic cervical spondylosis, conservative treatment has good efficacy, and a large number of clinical observations show that the efficacy of comprehensive treatment is optimal. Chinese medicine believes that deficiency of liver and kidney is the basis for the pathogenesis of cervical spondylosis, wind, cold and dampness is the cause, and blood stasis and qi stagnation is the pathological result. According to the pathological mechanism and clinical manifestations, it has become the consensus of the medical community at home and abroad to treat the disease by holistic compound sequential therapy.
4.What is the pathological mechanism of spinal cord type cervical spondylosis?
Cervical degeneration causes compression of the spinal cord, and the clinical manifestation is spinal cord cervical spondylosis. The disease is a chronic process and the spinal cord is very tolerant to chronic compression. Even if only 1/3 of the anterior and posterior diameter of the spinal cord is left due to compression, the patient can still be asymptomatic, which is one of the reasons why patients with spinal cord cervical spondylosis are diagnosed late. However, once symptoms appear, the disease progresses significantly faster, and there is even a risk of paralysis within a short period of time.
5.What are the main symptoms of spinal cord cervical spondylosis?
Spinal cord type cervical spondylosis mainly manifests as clumsy movement of both hands, making fine movements such as chopsticks, end bowls and unbuttoning difficult; unstable walking, easy to fall, drunken gait; hand and foot sensory disorders, numbness and swelling of both hands, a feeling of stepping on cotton in both feet, a feeling of girdling in the chest and abdomen; effort to urinate and defecate, often wetting clothes and pants, etc. In severe cases, the limbs are paralyzed, incontinent and bedridden.
6.Which diseases should be distinguished from spinal cord cervical spondylosis?
Most patients with spinal cord cervical spondylosis visit orthopedics late, mainly because the disease is mostly characterized by numbness of limbs and clumsy activities, which can be easily confused with cerebrovascular diseases such as cerebral infarction. Some patients even receive neurological treatment for more than half a year before they go to orthopedics, missing the best treatment time.
Secondly, the disease should also be distinguished from spinal cord diseases such as lateral sclerosis, spinal cord cavitation, and intraspinal tumor.
7.Why is surgery the radical treatment for spinal cord cervical spondylosis?
The main pathological change of spinal cord cervical spondylosis is the irreversible changes such as demyelination of nerve cells after spinal cord compression, which gradually aggravates the clinical manifestations. It is difficult to achieve satisfactory results with non-surgical treatment. Therefore, once the diagnosis is confirmed, surgery should be performed as early as possible to release the spinal cord compression in time to avoid the continued progress of pathological changes such as spinal cord nerve cell necrosis.
The surgical methods are divided into anterior surgery, posterior surgery and combined anterior and posterior surgery.
8.What is the curative effect of surgery for spinal cord cervical spondylosis?
Generally speaking, the efficacy of surgery for spinal cord cervical spondylosis is ideal, but the efficacy of the disease is closely related to the time and degree of spinal cord compression, which is directly related to the ratio of spinal cord nerve cell compression necrosis.
The shorter the spinal cord compression time, the better the surgical result; conversely, the longer the spinal cord compression time and the more severe the compression, the longer the recovery time of the patient and the worse the recovery result. Therefore, once the diagnosis is confirmed, surgery should be performed in time.
9.Is cervical spondylosis surgery dangerous?
Surgery for cervical spondylosis, whether anterior surgery or posterior surgery, is indeed a difficult surgery in orthopedics. However, with the continuous progress of surgical technology and surgical instruments, surgery for cervical spondylosis has become a routine surgery in orthopedics, and is becoming more and more minimally invasive.
Since cervical spine surgery was carried out in the first department of orthopedic injury in the 1990s, several hundred cases of cervical spine surgery have been successfully completed. All of them have achieved good results and relieved the patients’ sufferings, and have been well received by them.
10.How to prevent cervical spondylosis?
The main preventive measures for cervical spondylosis are to change the lifestyle that is not friendly to the cervical spine and to carry out the necessary cervical spine health care. Such as
(1) Failure to use the computer correctly: using it for too long, incorrect posture, inappropriate table and chair, excessive use of laptop computers, etc.
(2) Too low room temperature during sleep, poor bedding warmth, and inappropriate pillows.
(3) Uncivilized driving habits: sharp brakes and sharp turns, excessive mental tension.
(4) unhealthy entertainment: long hours playing mahjong, Internet, computer games, etc.
(5) excessive use of air conditioning, etc.
Exercises such as cervical spine health exercises, kite flying and swimming are beneficial to the health care of the cervical spine and are worth advocating.