cervical hypertrophy
Introduction
Introduction The so-called cervical hypertrophy refers to a symptom of neck pain, dizziness, hand numbness and other discomfort caused by hypertrophy of the cervical vertebra. The disease is medically known as cervical spondylosis or cervical syndrome. It is good for middle-aged and middle-aged people who are over 40 years old, especially those who are working in low-headed jobs and staying in a certain position for a long time in daily life and labor. If you look down, read, copy, etc. for a long time, it is easy to cause accumulated strain on the neck. The neck of a person is both heavy and active, so it is vulnerable to injury. In addition, as the age increases, the spinal canal undergoes degenerative changes as well as various tissues. When these two factors are added together, cervical spurs are formed, that is, hyperplasia of the cervical vertebrae occurs. If the hypertrophic spurs grow on the leading edge of the cervical vertebral body, no symptoms can be produced. Only when the bone spurs grow on the lateral or posterior edge of the vertebral body, protrude into the intervertebral foramen or spinal canal, and compress the vertebral artery, nerve root or spinal cord, which will cause neck pain, hand numbness, dizziness, headache, and limb weakness. , walking is not stable and so on.
Cause
Cause
The basic pathological change of cervical spondylosis is the degeneration of the intervertebral disc. The cervical vertebra is located between the skull and the thorax. The cervical disc has frequent activities under load-bearing conditions and is susceptible to excessive micro-injury and strain.
The main pathological changes are: early cervical disc degeneration, decreased water content of the nucleus pulposus and fibrous swelling and thickening of the annulus fibrosis, followed by glassy degeneration and even rupture. After cervical disc degeneration, the pressure resistance and tensile strength are reduced. When subjected to the gravity of the skull and the pulling force of the muscles of the head and chest, the degenerated disc can undergo localized or extensive bulging to the periphery, narrowing the intervertebral disc space, overlapping the articular processes, dislocation, and the longitudinal diameter of the intervertebral foramen. Become smaller. As the traction resistance of the intervertebral disc becomes weaker, when the cervical vertebra moves, the stability between adjacent vertebrae decreases and the intervertebral instability occurs, the mobility between the vertebral bodies increases and the vertebral body has a slight slippage, which then appears Bone hyperplasia of the posterior facet joint, hook joint and lamina, degeneration of the ligamentum flavum and ligament, cartilage and ossification.
Examine
an examination
Related inspection
Cervical vertebra CT examination neck test neck mobility test
1, neck type: 1 main complaints head, neck, shoulder pain and other abnormal feelings, accompanied by corresponding tender points. The 2X line upper cervical vertebra showed changes in curvature or intervertebral joint instability. 3 should exclude other diseases of the neck (shoulder, periarthritis, rheumatoid myofasthenia, neurasthenia and other non-intervertebral disc degeneration caused by shoulder and neck pain).
2, nerve root type: 1 has more typical root symptoms (numbness, pain), and the range is consistent with the area dominated by the cervical spinal nerve. 2 Indenter test or brachial plexus pull test is positive. 3 The findings of imaging are consistent with clinical manifestations. 4 pain point closure is not effective (can not be diagnosed if the diagnosis is clear). 5 Excluding cervical extra-vertebral lesions (thoracic outlet syndrome, tennis elbow, carpal tunnel syndrome, cubital tunnel syndrome, frozen shoulder, biceps tenosynovitis, etc.) caused by upper extremity pain.
3, spinal cord type: 1 clinical manifestations of strong cervical ridge damage. 2X-ray showed the posterior marginal vertebral hyperplasia and spinal stenosis. Imagery confirms the presence of spinal cord compression. 3 Excluding muscle atrophic spinal cord scoring, spinal cord tumor, spinal cord injury, secondary adhesive arachnoiditis, multiple peripheral neuritis.
4, vertebral artery type: the diagnosis of vertebral artery type cervical spondylosis is a problem to be studied.
1 had a stumble attack. And accompanied by cervical vertigo.
2 The neck test was positive.
3X line shows segmental instability or bone hyperplasia of the joint.
More than 4 with sympathetic symptoms. 5 Excluding eye-derived, otogenic vertigo.
6 Excluding the vertebral artery segment I (the vertebral artery segment before entering the neck 6 transverse process) and the vertebral artery segment III (the cervical vertebrae entering the intracranial vertebral artery segment) under pressure caused by basilar artery insufficiency.
7 vertebral angiography or digital subtraction vertebral artery angiography (DSA) is required before surgery.
5, sympathetic type: clinical manifestations of dizziness, vertigo, tinnitus, hand numbness, tachycardia, pain in the precordial area and other sympathetic symptoms, x-ray film instability or degeneration. Vertebral angiography negative.
6, other types: cervical vertebral body anterior ovary-like hyperplasia oppression caused by dysphagia (via esophageal sputum examination confirmed) and so on.
Diagnosis
Differential diagnosis
Cervical spondylotic radiculopathy needs to be differentiated from the following diseases
1. Cervical rib and anterior scalene muscle syndrome: The patient is younger, mainly characterized by dry compression under the brachial plexus, numbness of the medial extremities, atrophy of the intermuscular muscles and interosseous muscles. Because the subclavian artery is often compressed at the same time, the affected limb is pale and cool, and the radial artery beats weakened or disappeared. The Adson test (head turned to the affected side, temporary aspiration after deep inhalation, brachial artery beat weakened or disappeared) was positive. The neck film can confirm the neck ribs.
2. Intraspinal extramedullary subdural tumors, intervertebral foramen and peripheral neurofibromatosis, and tumors near the lung tip (Pancoast tumor) can cause upper limb pain. Cervical radiographs may reveal signs of lesions in the spinal canal and enlargement of the intervertebral foramen without cervical degenerative changes. CT or MRI can directly display tumor images, and Pancoast tlamor patients are also accompanied by Horner's syndrome.
