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 protrusions and intervertebral hernias, which ultimately leads to dysfunction of the spinal cord and is often the cause of the patient disability.
Features of the structure of the cervical spine
Vertebrae are the bones from which the spine is built. Each vertebra has a body that carries the entire load, the vertebral arch, the transverse and spinous processes.
The vertebral arches of the vertebrae form the vertebral canal where the spinal cord passes. The processes of the spine are designed to anchor the back muscles.
There are also anterior and posterior ligaments that connect the vertebrae together.
The intervertebral disc is a rounded flat structure consisting of a fibrous ring 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. Joint facets provide flexibility to the spine.
The intervertebral holes are foramina formed by structural elements (legs, articular processes) of two adjacent vertebrae and are intended for the exit of the radicular nerves of the spinal cord.
There are paravertebral muscles to support the spine and its various movements.
The cervical spine is the highest and most mobile part of the spine, which consists of seven vertebrae and has a C-shape due to its forward curvature (cervical lordosis).
All movements of the head - tilting, turning, circular, are provided by this part of the spine.
Interesting! Furthermore, the cervical spine is the most traumatized part, since the cervical vertebrae have a low and 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 the age of 30. This disease is more common in women than in men.
According to the World Health Organization, 40-90% of the world population suffers from osteochondrosis.
Important!One in two patients with osteochondrosis has dystrophic and degenerative changes of the spine in the cervical spine.
Causes of osteochondrosis of the cervical spine
Osteochondrosis can be called a tribute to a person's ability 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 deep understanding of human anatomy and physiology, it has not yet been possible to establish the specific causes of osteochondrosis.
But reliable factors are known that lead to degenerative-dystrophic changes in the spine. These include the following:
- insufficiently mobile lifestyle of a person, which leads to a weakening of the muscular system of the back. Often employees, cashiers, vendors and drivers suffer from osteochondrosis;
- hard physical work;
- mechanical back injuries;
- genetic predisposition to osteochondrosis;
- overweight and obesity;
- neuropsychic stress;
- improper workouts in the gym;
- beriberi, micronutrient deficiency, metabolic disorders;
- incorrect 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 lead to spasm of the back muscles. In turn, the muscle spasm disrupts the blood supply and metabolism of the bone tissue of the vertebrae and intervertebral discs.
Thus, dystrophic changes occur, in other words, dryness, dehydration and loss of elasticity of the vertebrae and intervertebral discs.
Further stress on the spine leads to flattening, protrusion (protrusion beyond the fibrous ring) 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 enormous, because the average weight of the head is 3-5 kg, and their bone tissue, unfortunately, is fragile and thin.
In addition, the development of osteochondrosis is facilitated by technical progress - smartphones, tablets, e-books, if it goes down while using these gadgets.
The intervertebral discs cannot efficiently cushion the spine, so 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 arthrosis.
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 a person's disability 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 the protrusion of the intervertebral discs, a decrease in the intervertebral cleft, the beginning of the destruction of the fibrous ring, which leads to pinching of the nerves, which is manifested in pain in the neck;
- The fibrous ring is completely destroyed and the nucleus pulposus extends beyond its borders, then an intervertebral hernia is formed and the vertebral column is deformed;
- Disability stage. 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 pain in the neck of a throbbing or aching nature, which may spread to the occipital region of the head, eye sockets, ears and shoulder girdle;
- pain in the upper limbs, which increases when they move;
- stiffness of movements of the upper limbs, violation of their sensitivity (tingling, burning, numbness), weakening of muscle strength;
- morning stiffness in the 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 vision disorders;
- feeling of numbness and tingling in the tongue;
- cardialgia (pain in the heart), sometimes cervical osteochondrosis is mistaken for acute coronary syndrome. The difference is the lack of effect of nitrates;
- due to microcirculation disorders and tissue oxygen deficiency, connective tissue proliferates in the cervical spine, the so-called "withers".
All symptoms of cervical osteochondrosis can be grouped into the following syndromes:
- reflex;
- root;
- radicular-vascular;
- spinal compression;
- cerebral.
Reflex syndrome consists of neck pain - intense pain in the neck, as a result of which the patient is forced to stare at the head and strain the neck muscles.
Feeling the spinous processes, paravertebral points and intervertebral discs leads and / or increases pain.
In addition, the reflex syndrome is characterized by pain in the upper limbs, occipital or temporal regions of the head.
Radicular syndrome is a combination of acute acute pain that increases with head movements and results from pinching of the nerves in the intervertebral foramen.
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 movement, decreased skin sensitivity, swelling of the hand and wrist joint. Also, the patient cannot bring his hands back.
Spinal compression syndrome occurs due to compression of the spinal cord and its vascular system. Herniated discs, osteophytes, thickening of the yellow ligament can lead to this.
Interesting!Patients have pain in the neck and shoulder region, flaccid paresis of the upper limbs and spastic paresis of the lower limbs, reduced sensitivity.
Cerebral syndrome with cervical osteochondrosis 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 limbs, increased sweating, chills;
- Posterior cervical sympathetic Barre syndrome or "cervical migraine" - intense headache, as with migraine in one half of the head on the background of dizziness, visual and hearing impairment, feeling of numbness in the hands.
- syncope syndrome - fainting with a sharp turn of the head;
- syndromes of the vestibular stem and cochlear stem - dizziness, instability when walking, nausea and even vomiting;
- visual disturbance syndrome - deterioration of 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, anamnesis, examination and auxiliary research methods.
In addition to the clinical examination, the patient must undergo the following modalities:
- X-ray of the cervical spine;
- Computed tomography of the cervical spine;
- MRI of the cervical spine;
- Doppler ultrasound examination of the vessels of the neck;
After diagnostic measures, the doctor chooses treatment tactics based on the results of diagnostics 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 removal of the inflammatory process.
In the acute period of the disease, it is necessary to comply with strict bed rest. The soft mattress should be replaced with a hard one, or it should be placed on top of a wooden shield.
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 load from the neck, but also limits movement;
- elongation with a glisson ring: the patient's head, which is lying on the bed, is fixed with a glisson ring, and the head of the bed is raised 20-30 cm. This procedure relaxes the muscular corset of the spine, increases the intervertebral fissures, releases pinched nerves;
- Manual therapy for cervical osteochondrosis should only be performed by an experienced manual therapist. Manual therapy is performed using relaxing and segmental massage techniques, mobilization, which restores damaged joint functions, and manipulations to restore the full range of motion of 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.
- Physiotherapy for cervical osteochondrosis includes exercises to strengthen the muscle corset. Exercise is suitable not only for the treatment of osteochondrosis, but also for prevention. They can be done before bed at home, at 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 drugs, with an increase in impaired motor and sensory functions of the upper extremities, as well as with 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;
- going to sports, gymnastics, walking. Swimming, yoga, pilates are great for this;
- all movements of the head should be precise, without sharp turns;
- correctly distribute the load on the spine during physical work and sports;
- take breaks and warm up during sedentary work;
- maintain correct posture while sitting at the table or computer;
- chairs and a table should be adequate for your height.