Spondylosis
Introduction
Introduction to spinal diseases Spinal diseases are the bones, intervertebral discs, ligaments, and muscles of the spine, which in turn cause compression and traction to stimulate the spinal cord, spinal nerves, blood vessels, and autonomic nerves, resulting in complex and diverse symptoms. Common diseases are cervical spondylosis and lumbar spondylosis. Main symptoms: can not stand upright, headache, dizziness, blurred vision, memory loss, neck and shoulder pain, loss of appetite, nausea, vomiting, weakness of the lower limbs, severe cases may lead to paralysis. Clinically, the treatment of spinal diseases mainly uses two methods, namely, surgical treatment and non-surgical treatment. Spine disease is a general term for diseases such as cervical spine injury, damage, dysfunction, and pathological changes in the neck, chest, waist, ankle, and tail. The main clinical manifestations of this disease are neck, chest and back, waist pain, and even implicated lower limb pain, which can aggravate symptoms whenever work and learning are intense, too tired or weather changes. In recent years, the incidence of the disease has become larger and larger, the age is getting smaller and smaller, and the symptoms are becoming more and more complicated. Even so, the vast majority of patients do not have the need for surgery, maintenance plus protection plus diet, can effectively prevent spinal diseases. basic knowledge The proportion of illness: 0.003% Susceptible people: middle-aged and elderly Mode of infection: non-infectious Complications: nausea and vomiting, esophageal stenosis, arrhythmia, hypertension, cervical spondylosis, breast pain, autonomic dysfunction
Cause
Cause of spinal disease
1. Incorrect postures, such as sitting, standing, lying, and working at the desk in the same position for a long time or other labor.
2, unreasonable bedding can cause ligaments, muscle tension is too large and strain, disc herniation, facet joint dysfunction.
3, cold, wet invasion, affect local blood circulation, accelerate tissue degeneration.
4, trauma will make the disease worse, chronic damage gradually caused the disease to worsen.
5, psychological factors and poor overall health, may cause or aggravate the symptoms of spinal disease.
Prevention
Spinal disease prevention
Spine disease is a general term for diseases such as cervical spine injury, damage, dysfunction, and pathological changes in the neck, chest, waist, ankle, and tail. The main clinical manifestations of this disease are neck, chest and back, waist pain, and even implicated lower limb pain, which can aggravate symptoms whenever work and learning are intense, too tired or weather changes. In recent years, the incidence of the disease has become larger and larger, the age is getting smaller and smaller, and the symptoms are becoming more and more complicated. Even so, the vast majority of patients do not have the need for surgery, maintenance plus protection plus diet, can effectively prevent spinal diseases.
Maintenance of bone strengthening protection:
1. Avoid obesity. Obesity can cause excessive load on the spine. At the same time, due to the relaxation of the abdominal muscles, it can not support the spine. The abdomen will force the spine to deform.
2. Learn to relax. Tension can increase the blood hormones, causing the lumbar disc to enlarge and cause low back pain. Therefore, a happy mood is also a good way to prevent and cure spinal diseases.
3. Correct sitting posture. If the body bends forward when sitting, it will cause the nerves and muscles in the lower back to be pulled and cause pain. Therefore, when sitting up, try to keep your back close to the back of the chair so that the waist muscles can relax and rest. Writing and stopping, stretching back, is also a good way to prevent low back pain.
4, sleep hard bed. If you have low back pain, you may want to go down from a comfortable soft bed such as Simmons, put the blanket on the floor and sleep for a week. Of course, it is better if you have a hard bed.
5. Choose the right exercise. Swimming is an effective exercise to enhance the strength of the back muscles. It has a good effect on cervical spondylosis, neck and shoulder pain, and lumbar and knee pain. However, diving, playing baseball, playing golf or doing gymnastics increases the risk of low back pain. Contracting the abdominal muscles, stretching the psoas and walking, rocking the waist and cycling can prevent and alleviate low back pain.
Precautions
1. Use the correct working posture, especially those who work in the same position for a long time should pay attention to appropriate activities.
2. Use reasonable and health-compliant bedding. Poor bedding is the bane of many spinal diseases.
3. The correct sleep posture.
4. Prevent excessive fatigue.
5. Prevent wind and cold from invading.
6. Strengthen exercise, especially on the neck and waist.
Complication
Spine disease complications Complications nausea and vomiting esophageal stenosis arrhythmia hypertension cervical spondylosis breast pain autonomic dysfunction
1. Dysphagia: There is an obstruction when swallowing, a foreign body sensation in the esophagus, and a few people have symptoms such as nausea, vomiting, hoarseness, dry cough, and chest tightness. This is because the anterior cervical vertebra directly compresses the posterior wall of the esophagus and causes esophageal stenosis. It may also be caused by the stimulating reaction of soft tissue around the esophagus due to the excessive formation of bone spurs.
2. Visual impairment: manifested as decreased vision, eye pain, fear of light, tearing, pupil size, and even reduced visual field and sharp vision loss, blindness can occur in individual patients. This is related to the autonomic nervous disorder caused by cervical spondylosis and the visual central ischemic lesion of the occipital lobe caused by insufficient blood supply to the vertebral-basal artery.
3. Cervical heart syndrome: manifested as pain in the precordial area, chest tightness, arrhythmia (such as stroke, etc.) and ST segment changes in the ECG, easily misdiagnosed as coronary heart disease. This is caused by the stimulation and compression of the cervical dorsal root spurs by the cervical spine.
4. Hypertensive cervical spondylosis: can cause blood pressure to rise or fall, which is caused by elevated blood pressure, called "cervical hypertension." Because cervical spondylosis and hypertension are common diseases in middle-aged and elderly people, they often coexist.
5. Chest pain: manifested as intractable unilateral pectoralis major and breast pain with slow onset, with pectoralis major muscle tenderness at the time of examination. This is related to the compression of the neck 6 and neck 7 nerve roots by the cervical spine.
6. Lower limb paralysis: Early manifestations of numbness, pain, and lameness in the lower limbs, some patients feel like walking cotton when walking, individual patients may also be accompanied by defecation, dysuria, such as frequent urination, urgency, poor urination or bowel movements Incontinence and so on. This is because the lateral bundle of the vertebral body is stimulated or compressed by the neck spur, resulting in lower limb movement and sensory disturbance.
7. Stumble: often when standing or walking, suddenly staggered and the body loses support and stumbles. After falling to the ground, it can be quickly awake, without consciousness disorder, and no sequelae. Such patients may be accompanied by symptoms of autonomic dysfunction such as dizziness, nausea, vomiting, and sweating. This is due to the hyperplasia of the cervical vertebrae, which causes the vertebral artery to cause the basilar artery blood supply disorder, resulting in a temporary lack of blood supply to the brain.
Symptom
Symptoms of spinal disease Common symptoms Visual impairment Neck and shoulder pain Dizziness Loss of appetite Memory impairment
The most common spinal diseases are cervical spondylosis and lumbar spondylosis. The main symptoms are not erect, headache, dizziness, blurred vision, memory loss, neck and shoulder pain, loss of appetite, nausea and vomiting, lower limbs, numbness, difficulty walking.
Juvenile spine disease
97% of the middle-aged and elderly people in China suffer from spinal diseases. In recent years, they have shown a trend of rejuvenation. Among people under 40 years of age, more than 40% of people have various diseases in the spine, and the incidence of scoliosis in children Up to 25% or more.
According to the survey, about 70%-80% of the total number of students in the correct posture in the middle and primary school students, all kinds of bad postures are easy to make the spine in the flexion position or certain specific position for a long time, which not only increases the pressure in the intervertebral disc. And also causes the muscle ligaments of the spine to be in a state of uncoordinated stress for a long time and a side bend occurs. In addition, human metabolic disorders, especially calcium, phosphorus metabolism and hormonal metabolism disorders, are prone to various spinal diseases.
When adolescents are long-lived, it is especially important to prevent and cure spinal diseases. First of all, to develop a good sitting position, standing position, do not sleep nylon silk trampoline and too soft Simmons bed, should use brown trampoline, wooden bed to maintain the balance of the spine. Study the gaps to do more neck movements, often shrug, pay attention to exercise.
In addition, we must pay attention to dietary calcium supplementation, ensure the normal metabolism of bones, and obtain the ideal peak of bone calcium. Eating high-quality protein and calcium-rich foods in the diet can significantly increase bone density and is beneficial for preventing spinal diseases.
Most susceptible to spinal disease occupation
The occupations most susceptible to spinal diseases are: entrepreneurs, computer engineers, designers, accountants, teachers, doctors, office workers, and those who work in the same posture for a long time have a higher probability of getting a spinal disease than other occupations.
Examine
Spinal examination
Spinal diseases can be used for a number of auxiliary examinations. The most widely used and most commonly used in the clinic is the spine X-ray film. Spinal X-ray plain film has special significance in clinical, it is more popular, and the routine examination is more valuable than cT and MRI, which is helpful for the determination of curative effect, and the nature, extent, degree and classification of the lesion. In addition to the spine X-ray film, there are many special photography, such as tomography, computed tomography (CT), nuclear magnetic resonance (MRl), myelography, other cerebral blood flow diagrams for functional testing, Electromyogram, evoked potential, etc.
Spine X-ray
Orthotopic: Observe the presence or absence of pivotal joint dislocation, odontoid fracture or absence. Whether the seventh cervical transverse process is too long, with or without neck ribs. Whether the hook cone joint and the intervertebral space are widened or narrowed.
Scoliosis
1. Change in curvature: the cervical vertebra is straight, the physiological protrusion disappears or the curve is reversed.
2. Abnormal activity: In the X-ray film of the cervical vertebrae overextension and overextension, the elasticity of the intervertebral disc can be seen to change.
3. Osteophytes: Osteophytes and ligament calcification can occur in the vertebral body near the intervertebral disc.
4. The intervertebral space is narrowed: the intervertebral disc can be thinned due to the nucleus pulposus, the water content of the intervertebral disc is reduced and fibrosis is formed, and the intervertebral space is narrowed on the X-ray film.
5. Semi-dislocation and intervertebral foramen become smaller: After intervertebral disc degeneration, the stability between the vertebral bodies is low, and the vertebral body often undergoes subluxation, or is called a vertebral column.
6. ligament calcification: ligament calcification is one of the typical lesions of cervical spondylosis.
Oblique position
The left and right oblique slices of the spine were used to observe the size of the intervertebral foramen and the hyperplasia of the hook joint.
Electromyography
The electromyogram of spondylosis and cervical disc herniation is due to the fact that cervical spondylosis or cervical disc herniation can cause long-term compression of the nerve root and degeneration, thereby losing the inhibition of the muscles that are innervated. Thus, the muscle fibers that have lost innervation can produce spontaneous contraction due to stimulation of a small amount of acetylcholine in the body. Therefore, the fiber potential appears in the muscles of the upper limbs on one or both sides, and occasionally a few tremor positions occur. When the force is contracted, the multiphase potential is normal and there is no large potential. When the force is contracted, it is completely disturbed. The average time and average potential of the motor unit potential are normal. The amplitude is 1~2 millivolts. Cervical spondylosis caused extensive degeneration of the intervertebral disc, causing bone hyperplasia. The range of damage to nerve roots is wider, and there are more muscles that are denervated. In patients with advanced lesions and longer duration, wave reduction and amplitude reduction may occur during active self-shrinking. The cervical disc herniation is often a single disc herniation, and the change is mostly on one side of the upper limb. The muscle area of the denervated nerve is obviously segmental.
CT examination of spinal disease
CT has been used to diagnose vertebral insufficiency, bone hyperplasia, vertebral rupture, ossification of the posterior longitudinal ligament, spinal stenosis, spinal canal enlargement or bone destruction, and measurement of bone density to estimate The extent of osteoporosis. In addition, soft tissue and subarachnoid space inside and outside the dural sheath can be clearly seen due to the transverse tomographic image. Therefore, it can correctly diagnose the intervertebral disc herniation and neurofibromatosis. The stenosis of the spinal cord or medulla oblongata has certain value for the diagnosis and differential diagnosis of cervical spondylosis.
Diagnosis
Diagnosis of spinal disease
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
First, the neck type (simple): X-ray film shows the disappearance of the lateral curvature of the cervical vertebrae and the double-shot performance of the facet.
Second, the nerve root type: cervical X-ray film positive position shows the hook vertebra joint degeneration hyperplasia, lateral position shows cervical curvature changes, such as physiological lordosis reduction, disappear or reverse bending. The lesional intervertebral space is narrowed. The oblique position shows that the intervertebral foramen becomes smaller.
Third, the spinal cord type: X-ray film can be seen typical cervical spondylosis changes. Myelography showed an L" or "U" shape of the diseased intervertebral disc.
Fourth, vertebral artery type: X-ray plain film can be seen in the hook joint hyperplasia, vertebral artery angiography can be seen vertebral artery distortion, thinning and compression phenomenon.
V. Sympathetic type: X-ray films have typical cervical spondylosis changes.
