Cervical spondylosis is one of the common and prevalent diseases among middle-aged and elderly people. Cervical spondylosis is a general term for the clinical symptoms and signs manifested after cervical spinal lesions. Currently, the latest diagnostic criteria for cervical spondylosis are.
1.The diagnosis can be confirmed if the clinical manifestations are consistent with what is seen in the imaging.
2, with typical clinical manifestations of cervical spondylosis and normal imaging, attention should be paid to the diagnosis of cervical spondylosis only after excluding other patients.
3, only abnormal imaging performance, but no clinical symptoms of cervical spondylosis, should not be diagnosed cervical spondylosis.
The diagnosis is based on the following respectively.
1.Cervical type.
(1) Complaints of abnormal sensations such as head, neck and shoulder pain, accompanied by corresponding pressure points.
(2) The cervical spine on X-ray shows changes in curvature or intervertebral joint instability and other manifestations.
(3) Other disorders of the neck should be excluded (drop pillow, frozen shoulder, rheumatic myofibrositis, neurasthenia and other shoulder and neck pain not caused by degenerative disc degeneration).
2.Nerve root type.
(1) With more typical radicular symptoms (numbness and pain), and the scope is consistent with the area innervated by the cervical spinal nerve.
(2) Positive pressure head test or brachial plexus pulling test.
(3) The imaging findings are consistent with the clinical presentation.
(4) No significant effect of painful point closure (this test may not be performed if the diagnosis is clear).
(5) Excluding the pain of the upper limbs caused by extra-cervical spine lesions (thoracic outlet syndrome, tennis elbow, carpal tunnel syndrome, elbow tunnel syndrome, frozen shoulder, biceps tenosynovitis, etc.).
3.Spinal cord type.
(1) Clinical manifestations of strong cervical spinal damage.
(2) X-ray film shows osteophytes and spinal stenosis at the posterior edge of the vertebral body. The presence of spinal cord compression is confirmed by imaging.
(3) Excluding amyotrophic spinal cord case sclerosis, spinal cord tumor, spinal cord injury, secondary adhesive arachnoiditis, and multiple peripheral neuritis.
4.Vertebral artery type: The diagnosis of vertebral artery type cervical spondylosis is a problem to be studied.
(1) There was a sudden collapse attack. It is accompanied by cervical vertigo.
(2) Positive rotational neck test.
(3) X-rays show segmental instability or osteophytes in the pivotal joints.
(4) Mostly accompanied by sympathetic symptoms.
(5) Exclude ophthalmogenic and otogenic vertigo.
(6) Inadequate blood supply to the basilar artery caused by compression of vertebral artery segment I (the segment of the vertebral artery before entering the transverse foramen of cervical 6) and vertebral artery segment III (the segment of the vertebral artery before exiting the cervical spine into the skull) should be excluded.
(7) Vertebral arteriogram or digital subtraction vertebral arteriogram (DSA) is required before surgery.
(5) Sympathetic nerve type.
Clinical manifestations are a series of sympathetic symptoms such as dizziness, dizziness, tinnitus, hand numbness, tachycardia, precordial pain, etc. There is instability or degeneration on x-ray. Negative vertebral arteriogram.
6, other types: cervical vertebrae anterior uvula-like hyperplasia compressing the esophagus causing dysphagia (confirmed by barium esophagogram), etc.