atlas groove ring deformity
Introduction
Introduction to the sacral ring deformity Gully ring deformity is not uncommon on the atlas, accounting for 2% to 3% of normal people. However, due to such malformation, the third segment of the vertebral artery (V-III) is compressed and the symptoms of vertebral artery insufficiency are rare, 1/10 of those who are not. basic knowledge The proportion of illness: 0.0005%-0.0007% Susceptible people: no specific population Mode of infection: non-infectious Complications: coma
Cause
Causes of ankle sulcus ring malformation
(1) Causes of the disease
The cause is unknown.
(two) pathogenesis
1. The occurrence of the sulcus ring: According to the theory of evolution, people evolved from sputum. This vertebral artery sulcus, which is ubiquitous on the atlas, is essentially a trace of degradation in human evolution. In this way, it is considered that when the crawling cockroach evolves into a person walking upright, the third segment of the vertebral artery is fixed, and the grooved ring of the braking effect has lost its anatomical significance, and thus gradually degenerates, showing the characteristics of disuse degeneration. .
2. Classification of the atlas vertebral artery groove
(1) Full-circle type: the skeletal structure is annularly covered above the vertebral artery groove, allowing the vertebral artery to pass therethrough.
(2) Semi-annular type: refers to those whose bone structure is not completely covered by the vertebral artery sulcus. Among them, the former semi-ring type is more common, the latter half-ring type and the side type are rare, and the anterior and posterior half-rings are relatively rare. Can be bilateral or single side, left more than right.
3. The relationship between the groove ring and the vertebral artery: Under normal circumstances, the V-III segment of the vertebral artery is relatively relaxed and has a certain degree of mobility, but the vertebral artery surrounded by the bone ring must pass through the bone with other blood vessels. Like the fiber duct, it is easy to have symptoms of distal blood supply due to flexion, sputum and compression; in addition, there are abundant sympathetic ganglion fibers around the vertebral artery, which further complicates the symptoms.
Prevention
Prevention of ankle sulcus ring deformity
1. Pay more attention to reasonable labor posture and good living habits. When lifting heavy objects, the hips and knees bend and squat, the back of the waist is straight, and the weight can be pressed against the body before it can stand up and step forward. When you are on the back or squatting, the chest is slightly curved, the hips and knees are slightly bent, and the steps are stable. The steps should not be large. When sleeping, the head and neck should be naturally neutral, the hips and knees should be slightly bent, and the body should be protected from the wind and damp.
2, sitting or working at the desk should not be too long, should avoid the soft tissue fatigue caused by maintaining a posture for a long time, before the strenuous exercise, pay attention to preparation activities and protection.
3. For occupations with high lumbar labor intensity, wear a wide belt with protective effect. Prevention of spinal stenosis must first have good living habits, such as not sitting or looking down too long.
Complication
Complications of ankle sulcus ring malformation Complications
1, urinary and dysfunction: urinary and bladder disorders generally appear later. In the early stage, it is weak in urine and urine. Frequent urination, urgency and constipation are common. In the advanced stage, urinary retention and incontinence can occur.
2, limp: the symptoms of the spine stretched back, the symptoms were relieved when flexion. A small number of patients have muscle atrophy in the lower extremities, and Achilles tendon reflexes sometimes weaken or disappear. It is also accompanied by the appearance of claudication symptoms.
3, limited activity: dyskinesia is mainly caused by vertebral canal stenosis, limb weakness, stiffness and inflexibility, from the most cause weakness of the lower limbs, heavy legs began to fall like a step of cotton, re-establishment gait Stable, easy to squat, need help with the wall or crutches to walk, the symptoms gradually increase as a quadriplegic appearance.
3, nerve root stimulation: nerve root stimulation symptoms, such as chest and back bandage, pain.
4, pain: there are obvious symptoms of low back pain. Patients often have low back pain when walking one or two hundred meters. After a short break or a squat, the symptoms will be relieved or disappeared immediately. If you continue to walk, the pain will appear again.
Symptom
Axillary sulcus ring deformity symptoms Common symptoms Nausea earache Hearing loss Fatigue Anorexia Cervical pain Tinnitus stun vertigo dizziness
1. Dizziness: The most common incidence, the incidence rate can reach more than 90%, more common in the neck movement, excessive or over-extension is easy to induce, especially when suddenly turning the neck.
2. Tripping: similar to the mechanism of V-II vertebral artery insufficiency, mainly due to basilar artery ischemia, the incidence is lower than the former, 50% to 60%.
3. Upper neck pain: more common, especially in the early stage of the disease, the incidence rate is more than 90%, the pain occurs at the junction of the occipitocervical neck, and the posterior occipital radiation, more consistent with the distribution of the first cervical spinal nerve .
4. Ocular symptoms: more common, the incidence is about 80%, mainly due to sympathetic nerve endings caused by irritation, mainly for eye pain, blurred vision and fatigue.
5. Ear symptoms: The same reason as the former, manifested as tinnitus, hearing loss and ear pain, etc., the incidence rate is about 60%.
6. Other symptoms: including headache, nausea, anorexia and other symptoms of cervical pain can occur.
Examine
Examination of ankle sulcus ring deformity
X-ray film, clearly showing the shape and side of the groove ring on the lateral position, CT and MRI examination, are helpful for diagnosis.
Diagnosis
Diagnosis and diagnosis of ankle sulcus ring deformity
Diagnostic criteria
1. X-ray film: The shape and side of the groove ring can be clearly displayed on the side piece.
2. Spinal neck test: Different from the compression of the vertebral artery of the hook joint, the lesion is located at the occipital neck. If the patient rotates the neck and presses the finger on the transverse side of the affected vertebra and simultaneously raises the patient's neck, Can induce symptoms of vertigo. Not necessary, generally do not need this check.
3. CT and MRI examinations are helpful for diagnosis.
Differential diagnosis
In addition to the identification of general occipital neck disorders, it should be differentiated from the affected diseases of the first and second vertebral arteries.
