Cervical osteochondrosis or osteochondrosis of the cervical spine is a common disease of those working in the field of knowledge. Rapidly progressive disease. Cervical osteochondrosis, complicated by the development of a herniated disc, is associated with an increased incidence of early strokes. MRI scan is required for diagnosis.
What is cervical osteochondrosis?
Cervical osteochondrosis is a common cause of neck pain, headache, pressure surges, shoulder pain, numbness of the fingers, pain under the shoulder blade. Currently, the incidence of cervical osteochondrosis has increased significantly as the role of the computer in our lives has increased.
However, a fall or injury can stimulate osteochondrosis, and degeneration (wear and tear) of the intervertebral discs over time can lead to symptoms.
Symptoms
In addition to moderate or mild pain, a feeling of stiffness in the neck and in some cases impaired mobility, many patients with cervical osteochondrosis experience numbness, tingling and even weakness in the neck, arm or shoulder as a result of chemical irritation and pinching of nerves in the cervical spine. .
For example, pinching a nerve root in the C6-C7 segment can cause weakness in the triceps, shoulder or forearm muscles, weakness in the wrist muscles, leading to a "sagging" arm, and a change in the sensitivity of the middle finger.
Cervical osteochondrosis also often leads to the development of stenosis (narrowing) of the spinal canal and other progressive conditions, such as intervertebral hernia. How does this happen?
Osteochondrosis is nothing more than a degeneration of the spinal structures, caused, as a rule, by the natural aging of the body. With age, there is a thickening of the ligaments, the formation of bone growths on the vertebrae and other changes. When the ligaments of the spine thicken or bone growths appear, as well as for a number of other reasons, there is less space left for the spinal cord and nerves inside the spinal canal. This condition is called stenosis, ie narrowing of the spinal canal. Severe narrowing of the spinal canal can lead to compression of the nerve roots or even the spinal cord itself.
Intervertebral hernia is also in most cases a consequence of degeneration. The intervertebral discs serve as shock absorbers between the vertebrae, thus preventing their destruction. Over time, the disc loses moisture and nutrients, flattens out, becomes more fragile and less elastic. As a result, a crack may form in the annular canal, through which part of the pulpal nucleus is pushed into the spinal canal. This condition is called an intervertebral hernia. If an intervertebral hernia presses on a nearby nerve root, pain syndrome and / or related neurological symptoms occur.
Diagnosis
Successful diagnosis of cervical osteochondrosis begins with consultation with a physician. The doctor collects the patient's medical history and performs a physical examination to check for mobility and sensitivity of the neck. During the examination, the patient may be asked to perform certain movements and report how the symptoms of pain change (increase or decrease).
If the examination shows that additional tests are needed, your doctor may recommend radiographic tests such as radiography, magnetic resonance imaging (MRI) or computed tomography (CT). These diagnostic tests with varying degrees of reliability can confirm the presence and location of osteochondrosis, as well as identify other conditions (such as calcification or arthritis) that may be causing the patient's symptoms.
The best option for X-ray examination at the moment is MRI, because with the help of magnetic resonance imaging it is possible to obtain high-quality detailed images not only of bone tissue, as in radiography, but also of soft tissues of the spine, including muscles, ligaments, vessels, nerves and intervertebral discs. CT is usually prescribed if there are any contraindications to MRI, the main of which is the presence of metal structures or devices in the body (artificial joints, pacemakers, etc. ). The quality of CT is lower than the quality of MRI, but they can also show the condition of the soft tissues of the spine.
Treatment of cervical osteochondrosis
Conservative (non-surgical) treatment of osteochondrosis is always recommended as the main strategy and surgical intervention is considered only if the complex conservative treatment for at least six months has not yielded results or if pain and other symptoms significantly interfere with the patient's daily life. .
Methods used in the conservative treatment of cervical osteochondrosis may include:
- tightening of the spine (traction). The recently used methods without loading the spine allow to completely eliminate the complications of this method of treatment, without which traction with a load is not possible. With increasing intervertebral distance, the nutrition of all intervertebral discs improves, the pain syndrome disappears.
- Therapeutic gymnastics. . Therapeutic gymnastics can improve the mobility of the spinal segment. In the mobile spinal segment, hernias and protrusions do not grow or form, as the intervertebral discs perform their function.
- mass therapy.
- drug therapy. Includes NSAIDs (non-steroidal anti-inflammatory drugs) and painkillers. In most cases, drug therapy has little or no temporary effect.
- cervical corsets, orthopedic pillows. They can be recommended to stabilize the cervical spine and reduce the pressure on the nerve root after trauma and fractures of the spine.
Surgical treatment of cervical osteochondrosis
If there is no significant relief after six months of conservative treatment and daily life becomes difficult for the patient, surgery may be considered. Cervical osteochondrosis usually involves a procedure called a spinal fusion to immobilize the affected spinal segment. This operation involves removing the intervertebral disc, decompressing the nerve root, and placing a bone or metal implant to maintain or create a normal disc space and stabilize the spinal segment.
As a rule, the fusion of the spine is performed on one vertebral segment, in rare cases, the question of performing surgery on two vertebral segments can be considered. However, the patient should be aware that surgery to relieve the symptom of neck pain is much less likely to lead to positive results than similar surgery to relieve pain in the arm with cervical osteochondrosis. Therefore, if neck pain is the main or only symptom, spinal fusion should be recommended only as a last resort or if all conservative treatments have been tried and failed. If disc space cannot be identified as the most likely source of neck pain, surgery is best avoided, even if conservative treatment does not provide significant pain relief. In addition, do not forget that spinal surgery can be performed with quite serious consequences both in the operated area (local infection, rejection of implants, etc. ) and for the whole body, blood clots, allergic reactions to drugs, etc. . ). ). Therefore, before deciding on surgical treatment, it is necessary to discuss all the details of the operation directly with the surgeon who will perform it. It should also be noted that surgery of the cervical spine most often leads to spinal cord injury.
What is cervical osteochondrosis?
Formal medicine interprets osteochondrosis as a degenerative-dystrophic lesion of the intervertebral discs.
From which part of the spine these discs are located, the definition of the disease is given.
Let's look in particular at the symptoms of cervical osteochondrosis, which accounts for almost 80% of all back diseases.
The sad factor is that the disease affects the category of patients aged 30 to 50 years, ie in the heyday of their ability to work.
In young people, the disease acts as a separate disease, in old age it is already a pathology that has developed against the background of other diseases of the joints.
How does the disease develop?
Each part of the spine is characterized by a gradual development of the disease. Cervical osteochondrosis does not go beyond this framework, so it is worthwhile to dwell in detail on each of its stages.
- In the initial stage, there is a gradual destruction of the intervertebral discs. Between them is a fibrous ring, in which cracks appear, leading to a decrease in the elasticity and strength of the discs themselves. They shrink and compress the nerve roots.
- The second stage is a consequence of the untreated first stage. The initial destruction of the discs becomes chronic, there is a thickening of the tissues, there are dislocations of the cervical spine. Falling head syndrome often develops at this stage.
- In the third stage, the pain sensations intensify, constant headaches appear, the sensitivity of the upper limbs is lost and the cervical "lumbago" is tortured. This is due to the fact that the fibrous ring is almost completely destroyed at this stage.
There is often a reduction in pain in third-degree cervical osteochondrosis. This happens when the cartilage tissue disappears and there is nothing to hurt.
Reasons
Given the prevalence of osteochondrosis in general, doctors began to study closely the causes of it. Many of the negative factors have been identified, but there is no definitive list. Here are the ones announced so far:
- sedentary way of life;
- all types of intoxications and infections;
- great physical activity;
- smoking;
- constant weight lifting;
- stress and nervous tension;
- uncomfortable shoes or an incorrect foot, which creates unnecessary pressure on the spine;
- malnutrition;
- frequent hypothermia and exposure to bad weather;
- age-related changes;
- spinal cord injury;
- bad heredity;
- abrupt refusal to train if they have done so for a long time.
Once you know the causes, it becomes clear that cervical osteochondrosis can occur at any age. And if in the beginning the symptoms of osteochondrosis are insignificant and are characterized by rare attacks of pain, then over time it turns out that it is impossible to turn the neck and it is difficult to tilt the head. And these are not the only dangers of the disease.
What is the danger of the disease
Our neck is a great worker. She participates all day, and her small vertebrae stoically withstand all our bends and tilts of the head. If the bones are displaced, the nerves are compressed and the blood vessels are compressed, and the spinal artery, which is responsible for feeding the brain, also passes through the cervical spine. The artery is compressed, the nerve root is compressed and the inflammatory process begins.
What does this lead to? Spinal stroke, ischemia, intervertebral hernia - these are the severe consequences of cervical osteochondrosis. Here we add a general decrease in mobility and the formation of osteophytes. As a result, we have a disability that threatens complete immobilization. With such a disappointing prognosis, it is important to quickly recognize the symptoms of cervical osteochondrosis.
Symptoms
The shortest way to identify osteochondrosis is the patient's complaints. So, what sensations does a person talk about if his cervical vertebrae are destroyed? The picture of the disease looks like this:
- dizziness;
- Strong headache;
- "Flies" and colored spots in the eyes on the background of headache;
- pain when turning, lifting weights;
- pain radiating to other organs (heart area, other organs).
Sometimes the signs of osteochondrosis can be classified among other diseases, but they can not be ignored, even if they are temporary.
Diagnosis and treatment
Continuing the feelings expressed by the patient, the neurologist proceeds to a more accurate diagnosis of the disease. A few years ago, only X-rays were in doctors' arsenal for diagnosing osteochondrosis. Computed tomography and magnetic resonance imaging are actively used today. They allow you to determine the exact stage of the disease.
After assessing the resulting picture, a specialist vertebral neurologist prescribes the necessary treatment. The first thing the doctor does is relieve the pain, then the swelling and inflammation. Such anti-inflammatory drugs are used to relieve pain. As we remember, squeezing the spinal artery disrupts the supply to the brain, which means it needs to be improved. This is done with the help of muscle relaxants.
Knowing that the symptoms and treatment of cervical osteochondrosis are related to the spine, massage and physiotherapy are necessarily included in the set of measures to improve health. The massage is performed by a professional and by the patient himself. There are also special exercises aimed at developing the cervical spine and restoring their mobility.