Osteochondrosis of the cervical spine or cervical osteochondrosis is a disease of degenerative-dystrophic genesis that affects the intervertebral discs and cervical vertebrae with the formation of intervertebral bulges and hernias, which eventually leads to a dysfunction of the spinal cord and is usually the cause of the patient's illness. disability.
Characteristics of the structure of the cervical spine.
The vertebrae are the bones from which the spine is built. Each vertebra has a body that supports the entire load, the vertebral arch, the transverse and spinous processes.
The vertebral arches of the vertebrae form the vertebral canal through which the spinal cord passes. The processes of the spine are designed to anchor the muscles of the back.
There are also anterior and posterior ligaments that connect the vertebrae.
The intervertebral disc is a flat, rounded structure consisting of an annulus fibrosus and a nucleus pulposus, the main function of which is shock absorption. The intervertebral discs are located between the vertebrae.
The facet joint is a mobile connection of the processes of two adjacent vertebrae. The facet joints provide flexibility to the spine.
Intervertebral foramen are holes that are formed by structural elements (legs, articular processes) of two adjacent vertebrae and are intended for the exit of the root nerves of the spinal cord.
There are paravertebral muscles to support the spine and its various movements.
The cervical spine is the most superior and mobile part of the spine, consisting of seven vertebrae and is shaped like a C due to its forward curvature (cervical lordosis).
All movements of the head: tilt, turn, circular, are provided by this part of the spine.
Interesting! In addition, the cervical spine is the most traumatized part, since the cervical vertebrae have little strength and a weak muscular apparatus, compared to others.
For the same reason, osteochondrosis of the cervical spine often occurs.
Prevalence of cervical osteochondrosis
Osteochondrosis of the cervical spine affects the working-age population over 30 years of age. This disease is more common in women than in men.
According to the World Health Organization, 40-90% of the world's population suffers from osteochondrosis.
Important!Every second osteochondrosis patient has dystrophic and degenerative spinal changes in the cervical spine.
Causes of osteochondrosis of the cervical spine.
Osteochondrosis can be called a tribute to the ability of a person to stand and walk on two legs. This opinion is confirmed by the fact that not a single animal that walks on all fours suffers from osteochondrosis.
Despite the availability of modern methods for diagnosing diseases and a thorough understanding of human anatomy and physiology, it has not yet been possible to establish the specific causes of osteochondrosis.
But reliable factors that lead to degenerative-dystrophic changes in the spine are known. These include the following:
- insufficiently mobile lifestyle of a person, which leads to a weakening of the muscular apparatus of the back. Often office workers, cashiers, salespeople, and drivers suffer from osteochondrosis;
- hard physical work;
- mechanical back injury;
- genetic predisposition to osteochondrosis;
- overweight and obesity;
- neuropsychic stress;
- improper workouts in the gym;
- beriberi, micronutrient deficiency, metabolic disorders;
- improper nutrition;
- the presence of diseases of the kidneys, digestive and endocrine systems;
- infectious diseases;
- frequent hypothermia of the body;
- congenital and acquired immunodeficiencies.
Pathogenesis (developmental mechanism) of cervical osteochondrosis
Almost all factors that contribute to the development of osteochondrosis provoke spasms of the back muscles. In turn, muscle spasm disrupts the blood supply and metabolism of bone tissue in the vertebrae and intervertebral discs.
Thus, dystrophic changes occur, that is, dryness, dehydration and loss of elasticity of the vertebrae and intervertebral discs.
Increased stress on the spine leads to flattening, bulging (bulging beyond the annulus fibrosus) of the intervertebral discs.
No less important in the pathogenesis of cervical osteochondrosis is the burden of holding and moving the head.
The load on the cervical vertebrae is huge, because the average weight of the head is 3-5 kg, and its bone tissue, unfortunately, is fragile and thin.
Also, the development of osteochondrosis is facilitated by technical progress - smartphones, tablets, e-books, if you bend over while using these devices.
The intervertebral discs cannot efficiently perform the amortization of the spine, therefore, compensatory mechanisms are activated.
Important!One of these mechanisms is the proliferation of osteophytes and the development of spondylosis.
False joints can also form along the posterior surface of the vertebrae of the cervical spine - uncovertebral osteoarthritis.
All these processes eventually lead to a decrease in cervical lordosis (hypolordosis), protrusions and intervertebral discs, which sooner or later become the main cause of disability of a person or require urgent surgical treatment.
The pathogenesis of cervical osteochondrosis can be divided into four stages:
- The onset of instability of the cervical vertebrae;
- The formation of protrusion of the intervertebral discs, a decrease in the intervertebral fissure, the beginning of the destruction of the fibrous ring, which leads to pinching of the nerves, manifested in pain in the neck;
- The annulus fibrosus is completely destroyed and the nucleus pulposus extends beyond its edges, resulting in an intervertebral hernia and the spinal column becoming deformed;
- Stage of disability. The vertebrae grow together. It is difficult for patients to move. Sometimes the condition can improve, but not for long.
Symptoms and syndromes in osteochondrosis of the cervical spine.
The main symptoms of cervical osteochondrosis include the following:
- persistent neck pain of a stabbing or painful nature, which may spread to the occipital region of the head, eye sockets, ears, and shoulder girdle;
- pain in the upper extremities, which increases when they move;
- stiffness of the movements of the upper extremities, violation of their sensitivity (tingling, burning, numbness), weakening of the strength in the muscles;
- morning stiff neck;
- pain in the cervical spine when moving the head;
- periodic dizziness with cervical osteochondrosis, darkening of the eyes, loss of consciousness with sharp turns of the head;
- feeling of tinnitus;
- hearing and visual impairment;
- numbness and tingling sensation on the tongue;
- cardialgia (pain in the heart), sometimes cervical osteochondrosis is confused with acute coronary syndrome. The difference is the lack of effect of nitrates;
- Due to microcirculation disorders and oxygen deficiency in the tissues, connective tissue proliferates in the cervical spine, the so-called "cross".
All the symptoms of cervical osteochondrosis can be grouped into the following syndromes:
- reflection;
- root
- radicular-vascular;
- spinal compression;
- cerebral.
Reflex syndrome consists of cervicalgia - severe pain in the neck, due to which the patient is forced to fix the head and tighten the neck muscles.
Feeling the spinous processes, paravertebral points, and intervertebral discs brings and / or increases pain.
In addition, the reflex syndrome is characterized by pain in the upper extremities, occipital or temporal regions of the head.
Root syndrome is a combination of sharp and acute pain that increases with head movements and arises from pinching of the nerves in the intervertebral foramen.
The radicular-vascular syndrome is characterized by vegetative-trophic disorders in the form of humeral-scapular periarthritis.
The patient is concerned about pain in the shoulder joint, stiffness of movements, impaired sensation of the skin, swelling of the hand and wrist joint. In addition, the patient cannot remove his hands.
Spinal compression syndrome occurs due to compression of the spinal cord and its vascular apparatus. Herniated discs, osteophytes, thickening of the yellow ligament can lead to this.
Interesting!Patients have pain in the cervico-shoulder region, flaccid paresis of the upper extremities and spastic paresis of the lower extremities, altered sensation.
Cervical osteochondrosis brain syndrome combines several of these syndromes:
- Diencephalic syndrome: increased irritability, neurasthenia, general weakness, insomnia, distraction. In severe cases, there is anxiety, numbness of the upper and lower extremities, increased sweating, chills;
- Posterior cervical sympathetic Barre syndrome or "cervical migraine" - severe headaches, as with migraine in the middle of the head, against the background of dizziness, visual and hearing impairment, feeling of numbness in the hands.
- syncope syndrome - fainting with a sharp turn of the head;
- vestibular stem and cochlear stem syndromes: dizziness, unsteadiness when walking, nausea and even vomiting;
- visual disturbance syndrome: impaired vision, visual disturbances, blinking of "dots", "flies" in front of the eyes.
Diagnosis of osteochondrosis of the cervical spine.
Like any diagnosis in medicine, the diagnosis of osteochondrosis of the cervical spine is established on the basis of the patient's complaints, medical history, examination, and auxiliary research methods.
In addition to the clinical examination, the patient must undergo the following methods:
- X-ray of the cervical spine;
- Computed tomography of the cervical spine;
- Magnetic resonance imaging of the cervical spine;
- Doppler ultrasound examination of the neck vessels;
After diagnostic measures, the doctor chooses treatment tactics based on the results of diagnoses and analyzes.
Treatment of osteochondrosis of the cervical spine.
Treatment of osteochondrosis of the cervical spine consists in the elimination of the root syndrome and the elimination of the inflammatory process.
In the acute period of the disease, you must adhere to strict bed rest. The soft mattress should be replaced with a hard one, or a wooden protector should be placed over it.
Drug therapy for cervical osteochondrosis is carried out using the following groups of drugs:
- non-steroidal anti-inflammatory drugs;
- drugs of the chondroprotective group;
- pain relievers and anti-inflammatory gels and ointments;
- vitamin preparations: ascorbic acid, retinol acetate, tocopherol acetate;
- calcium preparations;
- drugs that improve microcirculation in tissues;
- muscle relaxants.
Treatment of cervical osteochondrosis includes the following methods:
- wearing a special collar around the neck, which not only relieves the burden on the neck, but also limits movement;
- stretching with a glisson loop - the head of the patient, who is lying on the bed, is fixed with a glisson loop, and the head of the bed is raised 20-30 cm. This procedure relaxes the muscular corset of the spine, increases intervertebral fissures, releases pinched nerves;
- Manual therapy for cervical osteochondrosis should be performed only by an experienced manual therapist. Manual therapy is performed using relaxing and segmental massage techniques, mobilization, which restores the functions of damaged joints, and manipulations to restore the full range of motion in the joints.
- Physiotherapy methods for osteochondrosis of the cervical spine: diadynamic therapy, electrotherapy, laser therapy, shock wave therapy, balneotherapy, treatment with ultrasound and ultraviolet rays, magnetotherapy and other methods.
- Physical therapy for cervical osteochondrosis includes exercises to strengthen the muscle corset. Physical exercise is suitable not only for the treatment of osteochondrosis, but also for prevention. They can be done before bed at home, in the gym, at work, and at school during breaks.
Surgical treatment of cervical osteochondrosis.
Treatment with surgical methods is indicated for severe radicular syndrome, which cannot be relieved by medication, with increased impaired motor and sensory functions of the upper extremities, as well as compression of the spinal cord.
Important!Operations to remove herniated intervertebral discs and osteophytes are widely used.
Prevention of osteochondrosis of the cervical spine.
- healthy sleep on an orthopedic mattress;
- using a low pillow;
- Visit the sauna or bath regularly. The steam perfectly relaxes the neck muscles;
- you need to take a hot shower every day for at least 10 minutes;
- playing sports, gymnastics, walking. Swimming, yoga, and Pilates are great for this;
- all head movements must be precise, without sharp turns;
- correctly distribute the load on the spine during physical work and sports;
- take breaks and warm-ups during sedentary work;
- maintain correct posture while sitting at a table or computer;
- the chairs and a table should be suitable for your height.