Cervical spondylosis is a disorder in which there is abnormal wear on the cartilage and
bones of the neck (cervical vertebrae).Many people get on Cervical Spondylosis, there are no medicine to eat, our self-heating pain relief patch can help you
Cervical spondylosis is also called cervical vertebra syndrome, is cervical vertebra osteoarthritis, proliferative GengZhuiYan, syndrome of cervical nerve root, the floorboard of the cervical intervertebral disc TuoChuZheng, is a kind of to change on the basis of disease produces.Mainly due to the long-term strain and bone hyperplasia of cervical vertebra, or thickening of hernia of intervertebral discs, ligaments, causing compression of cervical spinal cord, nerve root or vertebral artery, appear a series of clinical syndrome of dysfunction.Section of vertebral instability, loose;Herniated or out;A bone spur formation;Ligament hypertrophy and secondary spinal canal stenosis, the neighboring stimulus or oppression of the nerve root, spinal cord, vertebral artery and cervical sympathetic nerve tissue, cause a series of symptoms and signs.
Cervical spondylosis can be divided into: neck type of cervical spondylosis, cervical spondylosis of nerve root type, myelopathic type was, vertebral artery type of cervical spondylosis, sympathetic cervical spondylosis type cervical spondylosis, esophageal pressure type cervical spondylosis.
The cause of
1. The degeneration of the cervical spine
Cervical degenerative change is a major cause of the onset of cervical spondylosis, one of the intervertebral disc degeneration is particularly important, is the structural degeneration of the cervical spine starting factors, and thus developed a series of pathological anatomy and pathology of cervical spondylosis physiological changes.Intervertebral disc degeneration;The emergence of the anterior cruciate ligament (2) intervertebral disc clearance and hematoma formation;(3) edge vertebral body bone spur formation;(4) in the rest of the cervical spine degeneration;(5) vertebral canal sagittal diameter and volume decreases.
2. The developmental cervical spinal canal stenosis
In recent years has clear cervical vertebra tube diameter, especially sagittal diameter, not only on the occurrence and development of cervical spondylosis, and the diagnosis and treatment of cervical spondylosis, operation method choice and prognosis judgement has a very close relationship.Some degeneration, cervical spine bone hyperplasia of fat, but it doesn't come on, the main reason is the cervical canal sagittal diameter wide, vertebral canal with larger compensation gap.And some of the patients with cervical vertebrae degeneration is not very serious, but the symptoms early and more severe.
3. Chronic strain
Chronic strain is refers to the range of normal physiological activities or local maximum tolerated value transfinite activities.Because of its different from obvious injury or accident in life, work, so easy to be ignored, but its occurrence and development of cervical spondylosis, treatment and prognosis has a direct relationship, this strain produced with arises mainly from the following three conditions:
(1) the bad sleep position because of its long duration and poor sleep position under a state of rest in the brain can't adjust, inevitably cause disorder of vertebral muscles, ligaments and joints of the balance.
(2) improper work pose a lot of statistical material shows that some of the workload is not big, strength is not high, but in a sitting position, especially lower the head to workers, high incidence of cervical spondylosis, including household enterprise, embroidery workers, office staff, typing copy is fitter, instrument assembly line, and so on.
(3) the improper exercise of normal physical exercise is helpful to health, but more than neck tolerance activity or movement, such as in head and neck for the load point body handstand or somersault, etc., all can increase the load of cervical vertebra, especially in the absence of correct guidance.
4. The congenital malformation of the cervical spine
In normal cervical health examination and comparison research, taken often find various abnormal cervical Duan Keyou can see, the bone obvious deformity accounted for about 5%.
Clinical manifestations of
Clinical symptoms of cervical spondylosis is more complicated.Mainly include the nape pain, upper limb numbness, weakness of lower limbs weakness, fingers, difficulty walking, dizziness, nausea, vomiting, and blurred vision, tachycardia, and swallowing difficulties.Cervical spondylosis clinical symptoms and pathological changes, organizational involvement degree and the individual differences.
1. The nerve root cervical vertebrasickness
(1) has the typical symptoms of root, numbness, pain, and dominated with cervical spinal nerve area is consistent.
(2) the pressure head test or brachial plexus pull test positive.
(3) imaging can see consistent with clinical manifestations.
(4) (closed *.
(5) except outside the cervical lesions such as thoracic outlet syndrome and carpal tunnel syndrome, cubital tunnel syndrome, periarthritis of shoulder, etc., which is mainly composed of upper limb pain caused by disease.
2. Myelopathic type cervical vertebra disease
(1) the clinical presentations of cervical spinal cord injury.
(2) X ray film shown on the trailing edge vertebral body bone hyperplasia, cervical stenosis.Imaging demonstrated a spinal cord compression.
(3) with the exception of amyotrophic lateral sclerosis, spinal cord tumors, spinal cord injury, multiple peripheral neuritis, etc.
3. The vertebral artery type of cervical spondylosis
(1) have cataplexy attacks.Accompanied by cervical vertigo.
(2) spin neck test positive.
(3) X ray film showed segmental instability or posterior atlanto-axial joint bone hyperplasia.
(4) associated with sympathetic symptoms.
(5) except eye source source sex, ear vertigo.
(6) with the exception of vertebral artery I period (6 transverse process into the neck hole before vertebral artery segment) and vertebral artery section III (the cervical vertebra to intracranial vertebral artery segment) before compression caused by basal artery blood supply insufficiency.
(7) before the operation line of vertebral artery angiography or vertebral artery angiography digital subtraction angiography (DSA).
4. Sympathetic cervical spondylosis
Clinical manifestations of dizziness, vertigo, tinnitus, hand hemp, tachycardia, the area before the heart pain and a series of sympathetic nerve symptoms, X ray film is steady or cervical spine degeneration.Vertebral artery angiography negative.
5. Esophageal pressure type cervical spondylosis
Cervical vertebra devices for beak hyperplasia oppressive esophageal dysphagia caused by () was confirmed by esophageal barium examination, etc.
6. The neck type of cervical spondylosis
Neck type of cervical spondylosis, also known as local type of cervical spondylosis, refers to the head, shoulder, neck, arm pain and the corresponding pressure point, there is no job X ray film and narrow gap obvious degenerative changes, but can have the change of the cervical vertebra physiological curve, vertebral instability and mild bone hyperplasia, etc.
1. Test of cervical spondylosis
Cervical spondylosis tests the physical examination, including:
(1) the former QuXuan neck test for patients with cervical proneness, ask it rotate to the left and right sides.Such as cervical vertebra pain, indicates a cervical vertebra small joint degeneration.
(2) the intervertebral foramen extrusion test (coping test) for patients with head to one side, the inspectors left palm on patients' on, his right hand clenched fists tapping the left back, then a limb radioactive pain or numbness, said power down to the intervertebral foramen smaller, a root damage;For severe root pain, inspectors overlap on the top of the head with both hands, under pressure, can induce or aggravate symptoms.When patients after head in a neutral position or there was a pressure test with a positive called Jackson head test positive.
(3) in patients with brachial plexus pull test head, inspectors a walking in patients with head and neck, the other one hand limb wrist, push and pull in reverse, to see whether patients with radiation or numbness, pain this is called Eaten test.Such as pull then forced the limb for internal rotation movement at the same time, it is called a Eaten strengthen test.
(4) the upper limbs stretch test after inspectors in the contralateral hand shoulder fixed role, the other one hand in patients with wrist, and it is backward, the stretching, gradually with increase of cervical nerve roots pull, if have limb radiation pain, cervical nerve root or compression or injury of brachial plexus.
Normal men over the age of 40, about 90% of women over the age of 45 are cervical vertebral body bone spurs.Reason has the change of X-ray plain film, does not necessarily have clinical symptoms.Will now associated with cervical spondylosis X-ray can see points mentioned below:
(1) is a watch without pivot ring joint dislocation, fracture or missing from the dentate.The seventh cervical vertebra transverse process for too long, for the neck rib.Hook vertebral joint and intervertebral disc for broadening or narrowing.
(2) side (1) before the change of cervical vertebra, physiological curvature of processes or reverse bending.(2) abnormal activity through a lateral flexion in cervical spine X-ray film, can meet the flexibility of the intervertebral disc has changed.(3) osteophyte fanterior close to the part of the intervertebral disc after all can produce osteophyte and ligament calcification.(4) narrow intervertebral disc can be because of the herniated intervertebral disc moisture content reduce fibrosis and thinning, performance on the X ray film for narrow intervertebral disc.(5) subluxation and intervertebral disc degeneration, intervertebral foramen smaller low between the stability of the vertebral bodies, vertebral subluxation, often happen or slippery vertebra.Paragraphs 6 ligament calcification of ligament calcification is one of the typical pathological changes of cervical spondylosis.
(3) oblique position was taken around the spine inclined slice, is mainly used to observe the size of the intervertebral foramen and hook vertebral joint bone hyperplasia.
3. The emg examination
Cervical spondylosis and cervical intervertebral disc herniation of emg examination can prompt nerve root compression and buckled for a long time, thus losing the dominated muscle inhibition.
CT examination at the 4.
After CT has been used to diagnose longitudinal ligament ossification, stenosis and spinal cord tumor bone destruction caused by vertebral canal to expand or, bone density measurement to estimate the degree of osteoporosis.In addition, due to the transverse ct images can clearly see inside and outside of soft tissue and subarachnoid epidural sheath.So it can correctly diagnosis of intervertebral disc herniation, nerve fibroma, spinal cord or medulla cavity disease, for diagnosis and differential diagnosis of cervical spondylosis has a certain value.
The differential diagnosis
1. With the following disease on cervical spondylosis of nerve root type identification
Before the neck rib and scalene syndrome, pulp outside under the stiff backbone intra-spinal canal tumors, intervertebral foramen and its peripheral nerve fibroma, near apex of tumor can cause upper limb pain, neuralgia, muscular atrophy, angina pectoris, polymyalgia rheumatica.
2. Myelopathic type was cervical spondylosis with the following disease identification
Amyotrophic lateral sclerosis, multiple sclerosis, spinal canal tumor and syringomyelia.
3. The vertebral artery type of cervical spondylosis with the following diseases
With the other causes of vertebral basilar artery blood supply deficiency, such as vertebral atherosclerosis and dysplasia.Identification of vertebral artery angiography is the most reliable method.
4. The cervical spondylosis with sympathetic nerve should be with the following disease identification
Coronary problems, neurosis, menopausal syndrome, dizziness caused by other reasons.
5. Esophageal pressure type cervical spondylosis with the following diseases identification
With esophagitis, esophageal dysphagia caused by discrimination.
6. The neck type of cervical spondylosis with chronic neck soft tissue damage identification
Due to lower the head to work for a long time, the head is often in the proneness of position, make the pressure ahead of the cervical intervertebral disc, nucleus pulposus backward-shift, stimulate the fiber ring and longitudinal ligament, after causing discomfort symptoms.
1. The swallowing disorder
Swallowing obstruction when feeling and esophageal foreign body sensation, a few people have nausea, vomiting, hoarseness, dry cough, chest tightness and other symptoms.This is due to cervical front direct pressure wall caused by esophageal stricture after esophageal, may also be formed because of bone spurs tachycardia caused the esophageal surrounding soft tissue irritation reaction.
2. Visual impairment
Show the vision decline, eye strain, afraid of light, tears, the size of the pupil, appear even narrow field of vision and vision, blind individual patients can also occur.This and autonomic nerve disorder caused by cervical spondylosis and vertebral - basilar artery blood supply deficiency of occipital visual central ischemic brain damage.
3. The neck heart syndrome
Show the area before the heart pain, chest tightness, arrhythmia () such as premature beat and electrocardiogram ST segment changes, easy to be misdiagnosed as coronary heart disease.This is nape nerve root cervical vertebra bone spur stimulus and oppression.
4. High blood pressure, cervical spondylosis
Can cause high blood pressure or lower, with increased blood pressure, is referred to as "neck of hypertension".Due to cervical spondylosis and hypertension are common diseases in the elderly, hence they often coexist.
5. Chest pain
Show the slow onset of stubborn sex unilateral pectoralis major and breast pain, check the pectoralis major muscle tenderness.This has to do with cervical 6 and 7 nerve root compression by cervical vertebra bone spurs.
6. Lower limb paralysis
The early performance for lower limb numbness, pain, limping, some patients were walking like a feeling of cotton, individual patients can also be associated with disorders of defecation and urination, such as frequency, urgency, micturition not free or incontinence, etc.This is because the vertebral CeShu oppressed by their stimulus or cervical vertebra bone spurs, lead to lower limb motor and sensory disorder caused by.
Often when standing or walking because suddenly appeared twist body loses support and cataplexy, could quickly alert after fall on the ground, not accompanied by disturbance of consciousness, also without sequelae.Such patients may be accompanied by dizziness, nausea, vomiting, sweating and other plant nerve function disorder symptoms.This is caused by cervical vertebra hyperplastic change compression vertebral artery basilar artery blood supply obstacles, lead to present caused by brain.
1. Drug treatment
Can be selectively used painkillers, sedatives, vitamins (B1, B12), for relief of symptoms have a certain effect.Try to use glucosamine sulfate and chondroitin sulfate to support treatment.Glucosamine sulfate and chondroitin sulfate is clinically used in the treatment of osteoarthritis, various areas of the body the cartilage protective agent with a certain degree of anti-inflammatory cartilage catabolism.Based studies have shown that glucosamine can inhibit the spinal nucleus pulposus cells producing inflammatory factor, and promote the synthesis of intervertebral disc cartilage matrix components sugar glycosaminoglycans.Clinical studies have found that within the intervertebral disc amino glucose injection can significantly reduce the intervertebral disc degenerative disease cause of low back pain, and improve the function of the spine.Case reports suggest oral glucosamine sulfate and chondroitin sulfate can reverse the disc degenerative change to some extent.
2. Exercise therapy
Each basic relieve symptoms of cervical spondylosis or a chronic condition, can start medical gymnastics in order to promote further eliminate symptoms and consolidate curative effect.Symptoms of acute phase appropriate local rest, unfavorable increase exercise stimulate.Has the obvious symptoms or progressive spinal cord compression taboo, especially cervical back movement should be taboo.Vertebral artery type cervical spondylosis with the neck rotation movement should be soft, slow, by appropriate control.
3. The traction treatment
"Pull" in the treatment of cervical spondylosis is one of the preferred method in the past, but in recent years, found that many patients with cervical spondylosis after use "pull", especially the patients with long time use "pull", cervical spondylosis did not reduce, aggravate.
Traction not only cannot promote the recovery of cervical physiological curvature, instead drawing straighten the cervical vertebra, instead of weakening cervical physiological curvature, therefore should be careful with traction therapy cervical spondylosis.
4. Massage massage therapy
Is is effective for the treatment of cervical spondylosis.Its role is treatment can relieve neck and shoulder muscles tense and spasm, restore cervical activity, release the nerve root and soft tissue adhesions to relieve symptoms, cervical spondylosis myelopathic type was generally prohibits gravity massage and reset, otherwise easy to aggravate symptoms, even can result in paraplegia, even early symptom is not obvious, generally also recommended surgery.
5. Physical therapy
In the treatment of cervical spondylosis, physical therapy can have a variety of effects.It is generally believed that the acute phase feasible ion penetration, ultrasonic, such as ultraviolet or moving between current;Pain relief after the use of ultrasonic, iodine ion penetration, induction or other heat treatment.
6. Temperature hot compress
This treatment can improve blood circulation, relieve muscle spasm, eliminate swelling to alleviate the symptoms, technique helps to make the risk of vertebral stability after treatment.This law can use hot towel and hot water bag and local connection, acute pain symptoms in patients with heavier when temperature is unfavorable for heat treatment.
7. The surgical treatment
Severely oppressed nerve root or spinal cord, surgical treatment when necessary.
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