Spondylosis is a disease of the bones, intervertebral discs, ligaments and muscles of the spine, which in turn compresses and stimulates the spinal cord, spinal nerves, blood vessels and vegetative nerves, resulting in complex and diverse symptoms. The common diseases are cervical spondylosis and lumbar spondylosis. Main symptoms: inability to stand upright, headache, vertigo, blurred vision, memory loss, neck and shoulder pain, loss of appetite, regurgitation, vomiting, weakness of lower limbs, and in severe cases, paralysis may result.
I. Treatment
There are two main clinical treatments for spondylosis.
1.Surgical treatment: mainly for patients with more serious symptoms, who have been ineffective with strict non-surgical treatment and whose bodies can still tolerate surgery.
2, non-surgical treatment: non-surgical treatment clinical methods are commonly used as follows.
(1) traction: the gap between the spinal pushing body is widened through the addition or the body’s own gravity, which is conducive to the return of the protruding nucleus pulposus, restore the normal vertebral body arrangement, relax the ligament tension, thereby reducing the compression and stimulation of the spinal cord and spinal nerve roots.
(2) Minimally invasive therapy: “hook activation”, this therapy is safe and effective, it uses the principles of Chinese medicine to release the pressure and tension around the lesion, loosening the adhesions of tissues, muscles, ligaments, fascia to achieve the role of vertical balance, and finally achieve the purpose of curing the disease.
(3) Fixed braking: the cervical and lumbar vertebrae are fixed and braked by shaped pillow, neck circumference and lumbar circumference, which can reduce the continued injury and facilitate the repair of ten injuries.
(4) Manipulation massage, massage: through special techniques to restore the vertebrae, small joints to normal physiological position and normal physiological curve so as to achieve the purpose of rehabilitation.
(5) physical therapy: through a variety of physical factors acting on the body (such as infrared, magnetic, electric), to play anti-inflammatory, pain relief, accelerate the purpose of recovery, to improve clinical symptoms is very effective.
(6) Closed: the distribution of drugs in the patient’s local, the effect is more obvious, but not suitable for long-term use.
(7) Chinese herbal treatment: Star Paste has good efficacy.
(8) Western medicine treatment: by taking or injecting western medicine, the drug is inhaled into the body.
The protection of the spine is the usual attention. Because long-term sitting posture, standing posture and even incorrect sleeping posture may lead to neck, shoulder, waist and leg pain or spinal disease, it is important to choose good bedding when sleeping.
Second, the method of relieving back pain
1, to reduce the bad habits of long lying, sitting, more exercise, exercise lumbar muscle.
2, pay attention to rheumatism: according to the season, add clothes at the right time, keep the waist warm to prevent cold, wind.
3, the posture of sleep: when sleeping, lying down, with a towel-type thing, pad in the waist, so that the waist slightly raised, which will protect the physiological curve of the lumbar spine.
4, in the study, work sitting posture, as often as possible to do chest and abdomen, sitting upright, (this posture in general, it is difficult to last, can sit straight for a while, rest for a while, in doing, and then rest).
5, external analgesic patch
Life methods to reduce back pain can only treat the symptoms, not the root cause. It is recommended that you must see a doctor immediately when your back pain attacks in order to really solve the back pain problem.
III. Clinical diagnostic examinations
(I) Test examination of cervical spine
The test examination of cervical spondylosis, that is, physical examination, does not require the use of instruments, and it includes.
1. Forward flexion and rotation test: make the patient flex his neck forward and ask him to rotate to the left and right. If there is pain in the cervical spine, it indicates degenerative changes in the small joints of the cervical spine.
2, intervertebral foramen squeeze test (pressure top test): make the patient’s head tilted to the affected side, the examiner’s left palm placed on the top of the patient’s head, the right hand clenched fist lightly tapping the back of the left hand, then there is radiating pain or numbness in the limbs, indicating that the force downward transmission to the intervertebral foramen becomes smaller, there is radicular damage; for radicular pain is very strong, the examiner overlapping hands placed on the top of the head, between the pressure, can induce or intensify the symptoms. A positive pressure test when the patient’s head is in a neutral or posterior extension position is called a positive Jackson head press test.
3, brachial plexus pull test: the patient lowers his head, the examiner holds the patient’s head and neck with one hand and the wrist of the affected limb with the other hand, pushing and pulling in the opposite direction to see if the patient feels radiating pain or numbness, which is called the Eaten test. If pulling and then forcing the affected limb for internal rotation, it is called the Eaten strengthening test.
4. Upper limb posterior extension test: the examiner places one hand on the shoulder of the healthy side to play a fixed role, and the other hand holds the patient’s wrist, and makes it gradually stretch backward and outward to increase the pulling on the cervical nerve root.
(B) CT examination
About 90% of normal men over 40 years old and women over 45 years old have bone spurs in the cervical vertebral body. Therefore, there are changes in X-ray plain film, not necessarily clinical symptoms. The X-ray findings related to cervical spondylosis are described as follows.
1.Orthogonal position: observe whether there is dislocation of the pivot joint, fracture or absence of the dentate process. The seventh cervical vertebra has no overgrowth of the transverse process, and there are no cervical ribs. The hook and cone joint and the vertebral space are not widened or narrowed
2. Lateral position.
Lateral curvature of the spine.
1, change of curvature: straightening of the cervical spine, loss of physiological protrusion or reverse curvature.
2, abnormal mobility: in the lateral X-ray of cervical hyperextension and hyperextension and hyperflexion, changes in the elasticity of the intervertebral disc can be seen.
3.Bone redundancy: Bone redundancy and ligament calcification can be produced in the front and back of the vertebral body close to the intervertebral disc.
4, narrowing of the intervertebral space: the intervertebral disc can be thinned because of the protrusion of the nucleus pulposus and the reduction of the water content of the intervertebral disc and fibrous degeneration, which is manifested in the X-ray film as narrowing of the intervertebral space.
5, subluxation and small intervertebral foramen: after the disc degeneration, the stability of the intervertebral body is low, and the vertebral body is often subluxed, or called slipped vertebrae.
6, calcification of the collar ligament: calcification of the collar ligament is one of the typical lesions of cervical spondylosis.
3, oblique position.
The left and right oblique films of the spine are taken, which are mainly used to observe the size of the intervertebral foramen and the osteophytes of the hook vertebral joint.
(iii) Electromyography of spondylosis.
(iv) electromyography.
Electromyography in spondylosis and cervical disc herniation is due to the fact that both cervical spondylosis and cervical disc herniation can cause degeneration of the nerve roots due to long-term compression, thus losing the inhibition of the innervated muscles. Thus, the muscle fibers that are denervated can produce spontaneous contractions due to the stimulation of small amounts of acetylcholine in the body. As a result, fiber potentials appear in one or both upper extremity muscles, and occasionally a few fascicular fibrillation sites. During small forceful contractions, the multiphase potentials are normal and no giant potentials appear. During large force contractions, the phase is completely disturbed. The average time frame and average potential of motor unit potentials were normal. The amplitude was 1-2 mV.
Cervical spondylosis is caused by extensive degeneration of the intervertebral discs, resulting in osteophytes. Damage to the nerve roots is more extensive, and more muscles appear to be denervated. In patients with advanced lesions and longer disease duration, a decrease in wave number and amplitude can occur during active self-induced contractions. In contrast, cervical disc herniation tends to be a single disc herniation, with changes mostly in one upper extremity and a distinct segmental distribution of innervated muscles.
(D) CT examination of spinal disease
CT has been used to diagnose insufficiency of arch closure, osteophytes, vertebral body fracture, posterior longitudinal ligament ossification, spinal stenosis, spinal canal enlargement or bone destruction due to spinal cord tumor, and to measure bone density to estimate the degree of osteoporosis. In addition, the soft tissues inside and outside the dural sheath and the subarachnoid space can be clearly seen on cross-sectional images. Therefore, it can correctly diagnose herniated discs and neurofibromas. The cavitation of the spinal cord or medulla oblongata is of certain value for the diagnosis and differential diagnosis of cervical spondylosis.
IV. Imaging diagnosis
1.Cervical type (simple): X-ray film shows the loss of lateral physiological arc of cervical spine and double shadow performance of articular protrusion.
2, neurogenic type: cervical spine X-ray shows degenerative hyperplasia of the hook vertebral joint in the frontal position and changes in the curvature of the cervical spine in the lateral position, such as reduction, disappearance or reverse curvature of the physiological anterior convexity. The lesioned vertebral space is narrowed. The oblique position shows that the intervertebral foramen is small.
3, spinal cord type: X-ray film shows typical cervical spondylosis changes. Myelogram shows an L- or U-shaped image of the lesioned intervertebral disc area.
4, vertebral artery type: X-ray plain film can be seen in the hook vertebral joint hyperplasia, vertebral artery imaging can be seen in the vertebral artery tortuous, thinning and compression phenomenon.
5, sympathetic nerve type: X-ray film with typical cervical spondylosis changes.
Five, maintenance of low back health eight recommendations
1, maintain a good weight: weight gain is usually unconscious, so we do not realize the impact of overweight on the body. Imagine what it would feel like if you were allowed to carry ten pounds of baggage every day?
2, exercise the abdominal and low back muscles: the entire trunk muscles, if strong, can well protect the low back from injury. Strengthen the movement, such as playing badminton, tennis, and even when cleaning the room, you can consciously exercise the muscles.
3, when lifting weights to maintain the correct movement: when lifting weights pay attention to the legs apart to keep the center of gravity stable. When squatting, pay attention to the abdomen, so that the lumbar spine always maintain good alignment.
4, strengthen the leg part of the strength exercise: In addition to trunk exercise, leg muscles also play an important role in maintaining good posture in terms of body mechanics. Strong leg strength can effectively share the burden of the lower back.
5, maintain flexibility: If the body is not flexible enough, waist injury can practice yoga, tai chi and other activities to enhance body flexibility and relieve lumbar muscle tension.
6, pay attention to maintain the correct posture: incorrect posture can make the intervertebral disc pressure, muscle tension, joint damage. Therefore, it is very important to maintain good posture to prevent low back pain.
7.Choose a proper bed: For patients with low back pain, choose a mattress of moderate hardness that can support the waist, not too soft and let the waist sink.
8, use a small pillow to cushion the waist: when taking a sitting position should use a small pillow to cushion the waist, every half hour can remove the small pillow for 5 minutes, so that the waist can often change position. Sitting for too long should stand up or walk around for a while, and do stretching action, so that the waist muscles get a rest.