radiculitis
Introduction
Introduction to spinal nerve root inflammation Spinal radiculitis is a general term for inflammatory and degenerative diseases of the spinal nerve root caused by a variety of causes. The lesion can invade the spinal nerve roots of any segment of the neck, chest, and waist. Clinically, cervical and thoracic nerve roots and lumbosacral nerves are most often involved, causing shoulder and back pain and low back pain. The onset of cervical and thoracic radiculitis is more common in acute and subacute, often manifested as pain, numbness, and weakness in the shoulder or arm of one or both sides. Pain often radiates along the lateral or medial distal side of the upper limb, coughing, exerting force and relieving It is aggravated. basic knowledge Sickness ratio: 0.0001% Susceptible people: no specific population Mode of infection: non-infectious Complications: sexual dysfunction
Cause
Causes of spinal radiculitis
Infection factor (45%):
There are many causes of spinal radiculitis, and the causes of sphingositis in the epidural and external segments are also different. The radiculitis in the inner segment of the membrane is often caused by infection, poisoning, and nutritional metabolic disorders.
Physical factors (45%):
Extra-membranous radiculitis often causes local cold, damp (caused neurotrophic vasospasm, ischemia, edema), muscle and transverse process trauma and inflammation, and the lesions of intraspinal spinal radiculitis are often extensive, and mostly Bilateral; the extra-membrane segment is often more limited, mostly unilateral.
Prevention
Spinal radiculitis prevention
1. Actively treat various diseases that cause this disease.
2. Develop good habits.
If patients with suspected radiculitis manifestations should be actively examined and diagnosed, early detection, early diagnosis, early treatment, thereby minimizing the patient's nervous system and motor system complications, improve patient outcomes, Improve the quality of life of patients.
Complication
Spinal radiculitis complications Complications
The sacral nerve root damage is heavier and there is a loss of bladder and sexual dysfunction. Keep the respiratory tract unobstructed, prevent and cure lung infections, turn over on time, change position, assist with drainage, and if necessary, tracheotomy, such as respiratory insufficiency, can be used as auxiliary breathing to avoid the death of the royal family due to respiratory failure. Keep warm and take antibiotics if necessary. If there is a physical activity disorder that requires active prevention of hemorrhoids, it is mainly to stop local compression, promote local blood circulation, and strengthen wound treatment.
Symptom
Symptoms of spinal nerve root syndrome Common symptoms Muscle atrophy Shoulder pain in the shoulders of the radioactive pain reflexes disappeared chronic low back pain with lower extremity numbness of the lower extremities, muscle...
The onset of cervical and thoracic radiculitis is more common in acute and subacute, often manifested as pain, numbness, and weakness in the shoulder or arm of one or both sides. Pain often radiates along the lateral or medial distal side of the upper limb, coughing, exerting force and relieving It is aggravated. The above symptoms are often obvious after being exposed to cold and fatigue, and are relieved after warming and rest. The hypersensitivity (early), diminished or disappeared (late) in the affected nerve root innervation area can be found; biceps and iliac crests The tendon reflexes weaken or disappear; the upper limb muscles may have a slight atrophy; the corresponding neck and thoracic vertebrae may have tenderness. In addition, small limbs may have autonomic symptoms such as changes in skin temperature and color, nutrition and sweat gland secretion disorders. In the acute phase of intramedullary spinal radiculitis, there may be a slight increase in cerebrospinal fluid protein and cells.
Examine
Examination of spinal radiculitis
1. Laboratory tests have an auxiliary significance for clinical diagnosis, and cerebrospinal fluid may have mild lymphocyte elevation.
2. Evoked potentials, muscles within the damaged range may exhibit denervated EMG changes, peripheral nerve movement and sensory conduction velocity are slowed, and sensory nerve evoked potentials are prolonged.
3. Head CT and MRI.
Diagnosis
Diagnosis and diagnosis of spinal nerve root inflammation
diagnosis
1. Onset can be acute and slow, often with infection, poisoning, nutritional and metabolic disorders, spinal diseases, paraspinal muscle trauma and inflammation, transverse trauma and other medical history.
2. Radioactive numbness and pain in the inner root of damaged nerve roots, such as intercostal neuralgia caused by thoracic radiculitis; cervical and thoracic radiculitis has shoulder and neck to upper limb ulnar or (and) temporal pain; Lumbosacral radiculitis manifests as lumbosacral to medial or lower extremity or (and) lateral and foot pain. Often caused by cold, cough, bowel movements, etc. or increased symptoms.
3. In the area of the anterior root of the affected nerve root, there are different degrees of lower motor neuron spasm: muscle weakness, muscle atrophy, sputum reflex or disappear. For example, the symptoms of cervical and thoracic nerve roots occur in the scapular and upper limbs; the symptoms of lumbosacral nerve roots are found in the lower limbs. The sacral nerve root damage is heavier and there is a loss of bladder and sexual dysfunction.
4. Cerebrospinal fluid may have mild lymphocyte elevation. Muscles within the damaged area may exhibit denervated EMG changes, and peripheral nerve movement and sensory conduction velocity are slowed down. The latency of sensory nerve evoked potential is prolonged.
5. When the lesion involves the arachnoid membrane, it is called meningeal-nerveitis. If the spinal cord is involved, it is called spinal cord-mening-neralitis, which can produce symptoms of spinal arachnoid inflammation.
6. There are symptoms and signs of the cause of the primary disease.
Differential diagnosis
1. Cervical spondylosis: Symptoms are similar to cervical and thoracic radiculitis, but generally more common in middle-aged and elderly people, may have dizziness or spinal cord involvement, slamming the top of the head or pressing from the top of the head to the neck, can cause pain in the upper limbs ( Spurling sign), cervical X-ray film or CT examination can be seen in cervical vertebra hyperplasia, intervertebral foramen stenosis or spur penetration into it, disc degeneration and other changes, cervical traction and other treatment can reduce symptoms.
2. Cervical spinal cord tumor: slow onset, progressive aggravation, early signs are often more limited, root symptoms are more prominent, lumbar puncture can show subarachnoid obstruction, cerebrospinal fluid protein quantitative increase, cell number is normal, see the spinal angiography The flow of the contrast agent in the lesion is blocked and filled.
3. Brachial plexus neuritis: more common in adults, with acute or subacute onset, the pain site often on one side of the supraclavicular fossa or shoulder, gradually expanding to the ipsilateral upper arm, forearm and hand, ulnar side The brachial plexus (at the supraclavicular fossa) has tenderness, which can induce or aggravate pain when pulling the upper limb.
4. Thoracic outlet syndrome: mainly caused by cervical ribs, anterior middle scalene muscle lesions and rib or clavicular deformities, local mass compression, etc., manifested as compression symptoms of upper limb nerves and blood vessels, radiation compression of the affected limbs When the subclavian artery is compressed, the skin of the hand is pale, cold, and even Raynaud. When the affected limb is overstretched and abducted, the pulsation of the radial artery weakens or even disappears.
In addition, it is still necessary to distinguish from syringomyelia, inflammation around the shoulder joint, and tenosynovitis of the biceps brachii.
