Sympathetic cervical spondylosis
Introduction
Introduction to sympathetic cervical spondylosis Sympathetic cervical spondylosis is caused by factors such as degeneration of the intervertebral disc and segmental instability, which causes stimulation of the sympathetic nerve endings around the cervical vertebrae and produces sympathetic dysfunction. Sympathetic cervical spondylosis has many symptoms, most of which are sympathetic excitation symptoms, and a few are sympathetic inhibition symptoms. Because the surface of the vertebral artery is rich in sympathetic nerve fibers, when the sympathetic nerve function is disordered, the vertebral artery is often involved, resulting in abnormal systolic and systolic function of the vertebral artery. Therefore, sympathetic cervical spondylosis is accompanied by multiple systemic symptoms, and often accompanied by insufficient blood supply to the vertebrobasilar system. The vast majority of sympathetic cervical spondylosis can be alleviated and cured by reasonable conservative treatment. There are many conservative treatment methods, such as cervical traction, acupuncture, electrotherapy, and external use of traditional Chinese medicine. basic knowledge The proportion of illness: 0.03% Susceptible people: no special people Mode of infection: non-infectious Complications: nausea and vomiting
Cause
Causes of sympathetic cervical spondylosis
Strain (20%):
Long-term position of the head and neck in a single posture, such as long hours of low-head work, prone to cervical spondylosis. Cervical patients less than 30 years old are mostly engaged in low-end work.
Head and neck trauma (15%):
50% of cervical spondylotic myelopathy is associated with neck trauma. Some patients have cervical spinal canal in a critical state due to cervical hyperosteogeny, cervical disc bulging, and soft tissue lesions in the spinal canal. Cervical trauma often induces symptoms.
Bad posture (20%):
Such as lying in bed watching TV, reading a book, sitting on a high chair, sleeping in a seat, etc.; sleeping on a sleeping car, the muscle protection is poor when sleeping, and neck injury is easy to occur when braking.
Chronic infection (15%):
Mainly pharyngitis, followed by dental caries, periodontitis, otitis media and so on. Inflammation in these areas stimulates soft tissue in the neck or causes soft tissue lesions in the neck and occipital region by enriching the lymphatic system. Some people think that chronic throat infection is an important factor in cervical spondylosis, which may affect the inflammation of soft tissue chronic strain and aggravate the condition.
Wind and dampness factor (10%):
Wind and cold factors in the external environment can reduce the body's tolerance to pain, which can cause muscle spasm, small blood vessels to contract, slow lymphatic reflux, soft tissue blood circulation disorders, and then produce aseptic inflammation. Therefore, the wind, cold and dampness factor is not only an inducement, but also a symptom of the disease caused by the cause.
Sterility of the cervical spine (5%):
Congenital small spinal canal and cervical degeneration are the basis of some cervical spondylosis. Foreign statistics 40-50 years old have degeneration, accounting for 25%, 55 years old and above have degeneration, accounting for 85.5%. The incidence of cervical spondylosis in the cervical spine and nerve root canal is 1 times higher than that in normal people.
Prevention
Sympathetic cervical spondylosis prevention
1, pay attention to proper rest: to avoid lack of sleep. Insufficient sleep, overworked tension, and constant maintenance of a fixed posture for a long time will lead to excessive nervousness of the nerves and strengthen the symptoms of cervical spondylosis.
2, change the use of pillow habits: the physiological curvature of the vertebra (referred to as the neck curvature) is not static. With the increase of age, the cervical vertebrae will have degenerative changes, cervical vertebrae hyperplasia, and thus the neck curvature will change, and even the neck curvature will be straight or reversed.
3, active exercise: especially the neck and back muscles exercise, correct exercise can strengthen muscle strength, strengthen the normal cervical curvature, increase the stability of the cervical spine biomechanical structure, while promoting blood lymphatic circulation, favorable for cervical spondylosis restore.
4, can use hot compress: to relieve local nervous muscle tension has a certain effect.
Complication
Sympathetic cervical spondylosis complications Complications, nausea and vomiting
Heart palpitations, chest tightness, nausea and even vomiting.
Symptom
Sympathetic Cervical Spondylosis Symptoms Common Symptoms Hearing Loss Dizziness Gastrointestinal Symptoms Dry Eyes Discomfort Insufficient Vision Frequently foggy fuzzy memory impairment pupil abnormal tinnitus eye swelling
1. Head symptoms: such as dizziness or dizziness, headache or migraine, head sinking, occipital pain, poor sleep, memory loss, difficulty focusing. Occasionally, due to dizziness and fall.
2. Eye, ear, nose and throat symptoms: eye swelling, dryness or tears, vision changes, blurred vision, fog in front of the eyes; tinnitus, ear block, hearing loss; nasal congestion, "allergic rhinitis", pharyngeal foreign body Feeling, dry mouth, vocal cord fatigue, etc.; taste changes.
3. Gastrointestinal symptoms: nausea and even vomiting, bloating, diarrhea, indigestion, hernia and pharyngeal foreign body sensation.
4. Cardiovascular symptoms: palpitations, chest tightness, heart rate changes, arrhythmia, blood pressure changes, etc.
5. The face or a certain limb is sweaty, sweatless, chills or fever, sometimes feeling painful, numb but not distributed according to the nerve segment or running.
The above symptoms are often associated with neck activity, aggravated when sitting or standing, and reduced or disappeared when lying down. There are many neck activities, long periods of bowing, long hours of work in front of the computer or obvious when tired, and better after rest.
6. Clinical examination: normal neck activity, soft tissue tenderness around the cervical spinous process or paravertebral facet joints. Sometimes it can be accompanied by changes in heart rate, heart rate, blood pressure, etc.
Examine
Examination of sympathetic cervical spondylosis
1. Test of cervical spondylosis
The physical examination of cervical spondylosis, including:
(1) Pre-flexion neck test: The patient's neck is flexed forward and rotated to the left and right. If there is pain in the cervical vertebra, it indicates that the cervical facet joint has degenerative changes.
(2) Intervertebral foramen crush test (cylinder test): the patient's head is biased to the affected side. The examiner's left palm is placed on the top of the patient's head, and the right hand clenches the fist and rubs the left hand back. The patient has radiation pain or numbness, indicating that the force is downward. The transmission to the intervertebral foramen becomes smaller and has root damage. For those with severe root pain, the examiner can use the hands to overlap on the top of the head and pressurize under the pressure to induce or aggravate the symptoms. A positive compression test occurs when the patient's head is in the neutral or posterior position and is referred to as the Jackson indenter test.
(3) Brachial plexus pull test: The patient bows, the examiner holds the patient's head and neck with one hand, and the other hand holds the wrist of the affected limb, pushing and pulling in the opposite direction to see if the patient feels radiation pain or numbness. This is called the Eaten test. If the patient is forced to perform an internal rotation while pulling, it is called the Eaten strengthening test.
(4) Upper limb extension test: The examiner is placed on the shoulder of the healthy side to fix the other hand, and the other hand is held on the wrist of the patient, and gradually stretches backward and outward to increase the traction of the cervical nerve root. If there is radiation pain in the affected limb, it indicates that the cervical nerve root or brachial plexus is under pressure or damage.
2. X-ray inspection
Men over 40 years of age, about 90% of women over the age of 45 have spurs of the cervical vertebral body. Therefore, there is a change in the X-ray film, which does not necessarily have clinical symptoms. The X-ray findings related to cervical spondylosis are now described as follows:
(1) 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 joint and the intervertebral space are widened or narrowed.
(2) Lateral position: 1 change in curvature The cervical vertebra is straight, the physiological protrusion disappears or the curve is reversed. 2 Abnormal activity in the cervical spine overextension and lateral position X-ray film, you can see the elasticity of the intervertebral disc has changed. 3 The epiphyseal vertebral body can produce osteophytes and ligament calcification in the vicinity of the intervertebral disc. 4 The intervertebral space narrowing the intervertebral disc can be thinned due to the nucleus pulposus, the water content of the intervertebral disc is reduced and the fibrosis is thinned, and the intervertebral space is narrowed on the X-ray film. 5 semi-dislocation and intervertebral foramen become small intervertebral disc degeneration, the stability between the vertebral bodies is low, the vertebral body often occurs subluxation, or called the vertebral. Six ligament calcification ligament calcification is one of the typical lesions of cervical spondylosis.
(3) Oblique position: The left and right oblique slices of the spine are mainly used to observe the size of the intervertebral foramen and the hyperplasia of the hook joint.
3. Electromyography
Electromyography of cervical spondylosis and cervical disc herniation can indicate that the nerve root is degenerated by long-term compression, thus losing the inhibition of the muscles that are innervated.
4. CT examination
CT has been used to diagnose spinal canal enlargement or bone destruction caused by posterior longitudinal ligament ossification, spinal stenosis, spinal cord tumor, etc., and bone density is measured to estimate the degree 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, the correct diagnosis of disc herniation, neurofibromatosis, spinal cord or medullary cavity cavity has a certain value for the diagnosis and differential diagnosis of cervical spondylosis.
Diagnosis
Diagnosis and diagnosis of sympathetic cervical spondylosis
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis: There is currently no objective diagnostic indicator. Clinical manifestations of sympathetic dysfunction and imaging showed segmental instability of the cervical spine. For patients with atypical symptoms, if the planetary ganglion is closed or the cervical spine is high-level epidural, the symptoms are alleviated, which is helpful for diagnosis. Except for other causes of vertigo:
(1) Otogenic vertigo: vertigo due to vestibular dysfunction in the inner ear. Such as Meniere's syndrome, intra-aneural hearing artery embolism.
(2) Eye-induced vertigo: ophthalmologic disorders such as refractive errors and glaucoma.
(3) Brain-derived vertigo: vertebral-basal artery insufficiency due to atherosclerosis, lacunar infarction; brain tumor; sequelae of brain trauma.
(4) vasogenic vertigo: vertebral artery V1 and V3 stenosis lead to vertebral-basal artery insufficiency; hypertension, coronary heart disease, pheochromocytoma and so on.
(5) Other causes: diabetes, neurosis, overwork, long-term lack of sleep, etc.
