cervical subluxation
Introduction
Introduction to cervical subluxation Cervical subluxation is mainly caused by mild displacement between the small joints between the vertebral bodies, generally two types of anterior dislocation and lateral dislocation, and the anterior dislocation is more common. Occurred in adults, children are rare. Symptoms of anterior cervical dislocation of the cervical spine are relatively mild, mainly in the local area, such as the neck is easily tired, local pain, soreness, fatigue; head and neck extension and flexion and rotation function is limited; neck muscle spasm, head and neck are leaning forward, feeling stiff; The spinous process and the spinous process space of the injured segment are swollen and tender, and the anterior side of the vertebral body may also have tenderness. basic knowledge The proportion of illness: 0.0085% Susceptible people: no specific population Mode of infection: non-infectious Complications: bone hyperplasia cervical spondylosis
Cause
Cervical subluxation cause
When the cervical vertebra suffers from flexion violence, or the cervical vertebrae in the flexion position are subjected to longitudinal compression, the frontal compressive stress of the affected vertebral body increases, and the posterior structure of the cervical vertebra is subjected to tensile stress. During the flexion movement of the vertebral body, the phase The instantaneous center of rotation of the adjacent vertebral body is located at the posterior position of the center of the intervertebral disc. At this time, the anterior part of the vertebral body is the fulcrum, the lateral stress side is the joint capsule, the interspinous ligament, the ligamentum flavum, etc. The continuous action of bending force and compressive force can produce two kinds of Happening:
If the compression violence is large, it may cause the vertebral body to collapse in front, and sometimes it may cause the cervical disc to protrude. If the violence does not cause the vertebral body fracture, the joint capsule of the tension side, the ligament can be torn, and the severe posterior longitudinal ligament is also Damaged, the external force continues to cause the two joints of the upper cervical vertebrae to slide forward and displace, and this forward sliding of the posterior small articular processes is related to the pathological basis of the intervertebral disc.
If the intervertebral disc performs well during the stress process, the instantaneous center of rotation does not change, and the external force received by the posterior small off is mainly the tension. Only when the joint capsule is torn, the dislocation may occur. When the disc is degenerated, the height is lowered, and the disc is lowered. Peripheral annulus fibrosus and ligaments are loose, and there are potential instability factors in the intervertebral segments. During the violent process, the intervertebral bodies are displaced or the instantaneous rotation center is moved backward or downward. The bending motion of the cervical vertebrae is generated between the posterior small articular processes. The large shear force slides on each other, causing the tear of the ligament and the tear of the small joint capsule. The damage of the posterior longitudinal ligament is also one of the causes of the damage of the intervertebral disc. After the external force is stopped, the contraction of the neck muscle can be half. The dislocated joint is retracted to its original position, but it is also maintained in a subluxation state due to the incarceration of the joint capsule or the obstruction of the small fracture piece.
Prevention
Cervical subluxation prevention
The disease is a traumatic disease, no preventive measures, pay attention to safety, and avoid trauma.
Complication
Cervical subluxation complications Complications, hyperosteogeny, cervical spondylosis
Cervical subluxation is easy to cause instability in the future, and the degeneration of the intervertebral disc is intensified. If this instability between the vertebral bodies persists, according to Wolf's law, the upper and lower vertebral bodies of the intervertebral disc must increase through the bone hyperplasia and increase the interbody contact surface. Stability, bone hyperplasia can cause the sagittal diameter of the spinal canal to become shorter, and the spinal cord is severely compressed, causing chronic spinal cord injury, and its clinical manifestations are similar to those of cervical spondylosis.
Symptom
Symptoms of cervical subluxation Common symptoms Head or neck bloating and jumping feeling Head and neck activity restricted neck Tough neck pain
Symptoms of anterior cervical dislocation of the cervical spine are relatively mild, mainly in the local area, such as the neck is easily tired, local pain, soreness, fatigue; head and neck extension and flexion and rotation function is limited; neck muscle spasm, head and neck are leaning forward, feeling stiff; The spinous process and the spinous process space of the injured segment are swollen and tender, and the anterior side of the vertebral body may also have tenderness.
Neurological symptoms are rare, even if they occur, they are not serious, sometimes manifested as symptoms and signs of nerve root stimulation, but the true meaning of cervical subluxation is that it is easy to cause instability in the future, the degeneration of the intervertebral disc is intensified, if the vertebral body This instability persists. According to Wolf's law, the upper and lower vertebral bodies of the intervertebral disc must pass the bone hyperplasia and increase the intervertebral contact surface to increase the stability. The hyperplasia of the bone can cause the sagittal diameter of the spinal canal to become shorter and severe. When the spinal cord is compressed, the spinal cord is chronically damaged, and its clinical manifestations are similar to those of cervical spondylosis.
Examine
Examination of cervical subluxation
Lateral X-ray films may have no abnormal signs. If the facet joints remain in the subluxation state, the lateral slices may show abnormal arrangement of the joints. Sometimes, extensional flexion dynamic imaging may be applied to show the damaged segments. Unstable, it is recommended that the patient prone or supine on the arched stent when shooting the flexion and extension. When the intervertebral displacement is found, the diagnosis can be confirmed.
In addition to X-ray films, some people use the moiré diagram to observe and judge the presence or absence of cervical instability.
Diagnosis
Diagnosis and diagnosis of cervical subluxation
The disease is not difficult to diagnose with other diseases through imaging examination. Lateral radiographs in the acute phase may have no abnormal signs. If the facet joint remains in the subluxation state, the lateral slice can show abnormal alignment of the joint. Extension and flexion dynamic imaging can sometimes be applied to show instability of the injured segment. It has been suggested that when shooting a flexion position, the patient is lying prone or lying on the arched stent, and when the intervertebral displacement is found, the diagnosis can be confirmed.
In addition to X-ray films, some people use the moiré diagram to observe and judge the presence or absence of cervical instability.
