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Cervical spondylosis, also known as cervical spine syndrome, is a general term for cervical osteoarthritis, hyperplastic cervical spondylitis, cervical nerve root syndrome, cervical disc prolapse, is a disease based on degenerative pathological changes. It is a disease based on degenerative pathological changes. It is mainly due to long-term cervical spine strain, osteophytes, or disc prolapse, ligament thickening, resulting in the cervical spinal cord, nerve root or vertebral artery compression, and a series of dysfunctional clinical syndromes. The symptoms include instability and loosening of the vertebral joints, protrusion or prolapse of the nucleus pulposus, formation of bone spurs, hypertrophy of ligaments and secondary spinal stenosis, which stimulate or compress the adjacent nerve roots, spinal cord, vertebral artery, and cervical sympathetic nerves and other tissues, causing a series of symptoms and signs.
The clinical symptoms of cervical spondylosis are complex. The main neck and back pain, upper limb weakness, numbness of the fingers, lower limb weakness, walking difficulties, dizziness, nausea, vomiting, and even blurred vision, tachycardia and dysphagia. The clinical symptoms of cervical spondylosis are related to the site of the lesion, the degree of tissue involvement and individual differences.
1. Neurogenic cervical spondylosis
(1) has more typical root symptoms (numbness, pain), and the scope is consistent with the area innervated by the cervical spinal nerve.
(2) A positive head-pressure test or brachial plexus pull test.
(3) Imaging findings consistent with clinical presentation.
(4) No significant effect of pain point closure.
(5) Excluding extracervical lesions such as thoracic outlet syndrome, carpal tunnel syndrome, elbow tunnel syndrome, frozen shoulder and other disorders caused by upper extremity pain.
2. Spinal cord cervical spondylosis
(1) Clinical manifestations of cervical spinal cord damage.
(2) Radiographs show osteophytes at the posterior margin of the vertebral body and spinal canal stenosis. Imaging confirms the presence of spinal cord compression.
(3) Excluding amyotrophic lateral sclerosis, spinal cord tumor, spinal cord injury, and multiple peripheral neuritis.
3. Vertebral artery-type cervical spondylosis
(1) There has been a sudden collapse episode. And accompanied by cervical vertigo.
(2) Positive neck rotation test.
(3) X-rays showing segmental instability or osteophytes of the pivot joints.
(4) Most often accompanied by sympathetic symptoms.
(5) Excluding ophthalmogenic and auricular vertigo.
(6) Inadequate blood supply to the basilar artery caused by compression of vertebral artery segment I (vertebral artery segment before entering the foramen of the transverse process of the cervical spine) and vertebral artery segment III (vertebral artery segment before exiting the cervical spine and entering the skull) is excluded.
(7) Vertebral arteriography or digital subtraction vertebral arteriography (DSA) is required before surgery.
4. Sympathetic cervical spondylosis
Clinical manifestations include a series of sympathetic symptoms such as dizziness, dizziness, tinnitus, numbness of the hands, tachycardia, and pain in the precordial region, and there is instability or degeneration of the cervical vertebrae in the X-ray. Vertebral arteriography was negative.
5. Esophageal compression cervical spondylosis
Cervical vertebrae anterior beak-like hyperplasia compression of the esophagus caused by dysphagia (confirmed by barium esophageal examination) and so on.
6. Cervical cervical spondylosis
Cervical cervical spondylosis, also known as localized cervical spondylosis, refers to the pain of the head, shoulders, neck and arms and the corresponding pressure points, and there is no obvious degenerative changes such as narrowing of the vertebral space in the X-ray, but there can be a change in the physiological curve of the cervical vertebrae, and the changes of the vertebral body interbody instability and mild osteochondrosis.