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 bumps and intervertebral hernias, which eventually lead to spinal cord dysfunction and is often the cause of the patient's disability .
Characteristics 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 through which the spinal cord passes. The spine processes are designed to anchor the muscles in the back.
There are also anterior and posterior ligaments that connect the vertebrae.
The intervertebral disc is a flat, rounded structure consisting of a fibrous ring and a nucleus pulposus, whose main function is shock absorption. Intervertebral discs are located between the vertebrae.
The facet joint is a movable connection of the processes of two adjacent vertebrae. The joints provide flexibility for the spine.
Intervertebral foramen are foramina that are formed by structural elements (legs, joint processes) of two adjacent vertebrae and are intended for the exit of the radicular nerves from the spinal cord.
There are paravertebral muscles to support the spine and its various movements.
The cervical spine is the upper and most mobile part of the spine, consisting of seven vertebrae and shaped like a C because of its forward bending (cervical lordosis).
All head movements - tilt, rotation, circle - are provided by this part of the spine.
Interesting! Furthermore, the cervical spine is the most traumatized part, since the cervical vertebrae have low strength 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 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 patient with osteochondrosis has dystrophic and degenerative spinal changes 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 view is confirmed by the fact that no animal that walks on four legs suffers from osteochondrosis.
Despite the availability of modern methods for diagnosing diseases and a thorough knowledge of human anatomy and physiology, it has not yet been possible to establish the specific causes of osteochondrosis.
But reliable factors are known to lead to degenerative dystrophic changes in the spine. This includes the following:
- insufficiently mobile lifestyle of a person, which leads to the weakening of the muscular apparatus of the back. Office workers, cashiers, salespeople and drivers often suffer from osteochondrosis;
- heavy physical work;
- mechanical back injury;
- genetic predisposition to osteochondrosis;
- overweight and obesity;
- neuropsychic stress;
- improper exercises in the gym;
- beriberi, micronutrient deficiency, metabolic disorders;
- inadequate nutrition;
- the presence of kidney, digestive and endocrine diseases;
- infectious diseases;
- frequent body hypothermia;
- congenital and acquired immunodeficiencies.
Pathogenesis (developmental mechanism) of cervical osteochondrosis
Almost all of the factors that contribute to the development of osteochondrosis lead to back muscle spasm. 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.
More stress on the spine leads to the flattening, protrusion (protrusion beyond the ring fibrous) 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, as the average head weight is 3 to 5 kg and its bone tissue, unfortunately, is fragile and thin.
Furthermore, the development of osteochondrosis is facilitated by technical progress - smartphones, tablets, e-books, if you lean when using these devices.
Intervertebral discs cannot efficiently carry out spinal amortization, 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 - uncovered arthrosis.
All of 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 in the cervical vertebrae;
- The formation of protrusion of the intervertebral discs, reduction of the intervertebral fissure, beginning of the destruction of the fibrous ring, which leads to pinching of the nerves, which manifests as pain in the neck;
- The annulus fibrosus is completely destroyed and the nucleus pulposus extends beyond its edges, forming an intervertebral hernia and deforming the spine;
- Disability stage. The vertebrae grow together. It's 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, throbbing or painful in 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 in the 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 sudden turning of the head;
- tinnitus sensation;
- hearing and visual impairment;
- numbness and tingling sensation in the tongue;
- Cardialgia (heart pain), sometimes cervical osteochondrosis, is confused with 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:
- reflection;
- root;
- root-vascular;
- spinal compression;
- brain.
The reflex syndrome consists of neck pain - severe pain in the neck, in which the patient is forced to fix the head and strain 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 limbs, occipital or temporal regions of the head.
Root syndrome is a combination of sharp, sharp pain that increases with head movements and arises from pinched nerves in the intervertebral foramen.
Radicular-vascular syndrome is characterized by trophic-vegetative disorders in the form of humeral-scapular periarthritis.
The patient is concerned about pain in the shoulder joint, stiffness of movement, impaired 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 apparatus. Herniated discs, osteophytes, thickening of the ligamentum flavum can lead to this.
Interesting!Patients present with pain in the cervico-shoulder region, flaccid paresis of the upper limbs and spastic paresis of the lower limbs, impaired 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 in the upper and lower extremities, increased sweating, chills;
- Posterior cervical sympathetic Barre syndrome or "cervical migraine" - severe headaches, as with migraine in one half of the head in the context of dizziness, visual and hearing impairment, feeling of numbness in the hands.
- syncope syndrome - fainting with a sharp turn of the head;
- vestibular trunk and cochlear trunk syndromes - dizziness, instability when walking, nausea and even vomiting;
- visual disturbance syndrome - deterioration of vision, visual disturbances, flashing of "dots", "flies" in front of the eyes.
Diagnosis of osteochondrosis of the cervical spine
As with any medical diagnosis, the diagnosis of osteochondrosis of the cervical spine is established based on the patient's complaints, medical history, examination, and ancillary 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 neck vessels;
After the diagnostic measurements are taken, the physician chooses treatment tactics based on the results of the diagnoses and analysis.
Treatment of osteochondrosis of the cervical spine
The treatment of osteochondrosis of the cervical spine consists of eliminating the radicular syndrome and removing the inflammatory process.
In the acute period of the illness, you should adhere to complete bed rest. The soft mattress should be replaced with a hard one or a wooden pad should be placed over it.
Drug therapy for cervical osteochondrosis is performed with the following groups of drugs:
- nonsteroidal anti-inflammatory drugs;
- drugs of the chondroprotective group;
- analgesics and anti-inflammatory gels and ointments;
- vitamin preparations - ascorbic acid, retinol acetate, tocopherol acetate;
- calcium preparations;
- drugs that improve microcirculation in tissues;
- muscle relaxants.
The treatment of cervical osteochondrosis includes the following methods:
- wearing a special collar around the neck, which not only relieves the load on the neck, but also limits movement;
- stretching with a glisson strap - the patient's head, which is lying on the bed, is secured with a glisson strap, and the head of the bed is raised 20-30 cm. This procedure relaxes the spinal muscular corset, increases intervertebral fissures, releases pinched nerves;
- manual therapy for cervical osteochondrosis should only be performed by an experienced manual therapist. Manual therapy is performed through relaxing and segmental massage techniques, mobilization, which restores damaged joint function, and manipulations to restore 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 muscular corset. Exercise is suitable not only for the treatment of osteochondrosis, but also for its prevention. They can be done before going to 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 with medication, with increased impaired motor and sensory functions of the upper limbs, as well as spinal cord compression.
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. Steam relaxes the neck muscles perfectly;
- you need to take a hot shower every day for at least 10 minutes;
- playing sports, gymnastics, walking. Swimming, yoga, 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 when sitting at the table or computer;
- chairs and table should be suitable for your height.