Cervical radiculitis — the simptomokompleks arising at defeat of spinal backs in cervical department of a backbone. It is characterized by pain, paresteziya, gipesteziy, muscular weakness and atrophies in a neck, hands, the top part of a humeral belt. Cervical radiculitis is established on symptomatology and data of survey. Additional inspections are sent to search for causal pathology and include a X-ray analysis, MRT, KT, EMG. Conservative treatment is performed in a complex with use of anti-inflammatory, neurotyre-tread, vascular medicines, physical therapy, manual therapy, LFK, reflexotherapy and massage.
In cervical department there are 7 vertebras from which from two parties there are spinal backs originating in a spinal cord, or spinal nerves. In total there are 8 couples of cervical backs since the first couple leaves over the 1st cervical vertebra, between it and the basis of a skull. Defeat of one or several cervical spinal backs causes cervical radiculitis.
Cervical radiculitis — the second for occurrence frequency a radiculitis form. The first place belongs lumbar sacral to radiculitis. The statistics specifies that about 95% of cases of cervical radiculitis are caused by backbone osteochondrosis. The highest incidence falls on the age period from 50 to 55 years. With complaints to pain in a neck see a doctor of 10-12% of people of this age. On average in population cervical radiculitis leads 5% of people to disability.
In neurology cervical radiculitis carries also the name a tservikalny radikulopatiya. Modern clinical physicians note a tendency to decrease in age peak of incidence. Relevance of cervical radiculitis for neurology, orthopedics and a vertebrologiya is caused by its prevalence, damage of faces of working-age, the probable secondary nature of defeat of backs (for example, at oncological process in a backbone.
Reasons of cervical radiculitis
Osteochondrosis of cervical department of a spine column acts as the most frequent etiofaktor provoking cervical radiculitis. Formation of osteofit or as speak in the people, "adjournment of salts", renders irritant action on a spinal back in the place of contact with it. The chronic irritating influence leads to a back inflammation — radiculitis. The osteofita increasing in sizes can squeeze a back over time, causing its compression which is aggravated with inflammatory hypostasis. Besides, osteochondrosis is followed by decrease in height of intervertebral disks and can be complicated by hernia of cervical department which, in turn, squeezes a back.
As the other causes causing cervical radiculitis spine injuries in cervical department, incomplete dislocations of cervical vertebras, disorders of blood circulation (for example act, at diabetes, vaskulita), ekstramedullyarny tumors of a spinal cord, kraniospinalny tumors. Anomalies and curvatures of a backbone in this department can promote developing of radiculitis: some vertebrobazilyarny anomalies, cervical scoliosis or . At advanced age cervical radiculitis can arise against the background of a cervical spondilez. Separate cases are connected with defeat of backs the surrounding herpes though usually herpetic infection provokes chest radiculitis.
Symptoms of cervical radiculitis
In an initial stage of radiculitis the clinical manifestations connected with irritation of a back prevail. Sharp painful paroxysms which are provoked by turn or a ducking are characteristic. Localization of pain depends on what back is struck. Most often the lower cervical backs are surprised. In 5% of cases — C5, in 20% - C6, in 60% - C7, in 10% - C8. At pathology of C2-C3 the pain in occipital area irradiating in an ear, a mastoidal shoot is noted. Cervical radiculitis of C4-C5 demonstrates neck pain, a nadplechya and the top part of a shoulder, C6-C7 — pain on the external surface of a shoulder and the back surface of a forearm, C8 — on hand inside.
The pain syndrome provokes tension of cervical muscles, forces the patient to limit the movements to the head. It can be combined with the paresteziya occupying the same areas, as pain. Patients with cervical radiculitis have problems with falling asleep as they cannot find situation, convenient for the head. They often wake up because of neck and hands pains. On this background development of an insomniya (sleeplessness) is possible. Over time pain accepts subsharp and chronic character, becomes almost constant with the aggravation periods arising at the sharp movements in cervical department, sneezing, cough.
The compression of a back is clinically shown by symptoms of loss of its function: a sleep of the site of a neck, a shoulder or a hand corresponding to a back, weakness of muscles of a shoulder and hand, muscular atrophies. If cervical radiculitis has secondary character, then its clinic is combined with symptoms of the main pathology (a tumor, a trauma, a vascular disease). At a hernia nuclei pulposi of cervical department against the background of radiculitis there can be a syndrome of a vertebral artery — violation of blood circulation in basal departments of a brain with dizziness and a vestibular ataxy.
Diagnosis of cervical radiculitis
Complaints of the patient not always indicate defeat of cervical department of a backbone. At radiculitis of the top cervical backs patients can address the neurologist or the therapist concerning headaches, at an inflammation of the lower cervical backs — concerning shoulder or hand pains. Survey of the patient allows to define that the problem actually is in a backbone. Points morbidity at a palpation to it paravertebralny (located sideways from a backbone) points. Survey also reveals the tonic tension of cervical muscles more expressed on the struck party. At the same time it is necessary to differentiate cervical radiculitis with a cervical miozit. The gipesteziya (decrease in sensitivity) and muscular weakness revealed at assessment of the neurologic status testify to a compression of a cervical back.
Cervical radiculitis is diagnosed by the neurologist, the therapist, vertebrology or the orthopedist according to clinical data. However it is important to establish its reason. For this purpose conduct tool examination: X-ray analysis, backbone KT or MPT, general blood test, electromyography (EMG). At detection of data for tumoral process consultation of the oncologist is required.
Blood test usually shows inflammatory changes. The X-ray analysis of a backbone allows to find curvatures, incomplete dislocations, reduction of height of intervertebral disks, existence of osteofit, destruction of tissues of vertebras (at a tumor). Backbone KT visualizes its bone structures in more detail. However to estimate a condition of backs and other myagkotkanny components, it is possible to reveal their tumoral defeat only with use of MRT of cervical department. EMG allows to exclude muscular the nature of a disease and to establish what back is squeezed.
Treatment of cervical radiculitis
In an initial stage cervical radiculitis, as a rule, well gives in to conservative therapy. It is carried out by anti-inflammatory medicines (an ibuprofen, diclofenac, nimesulidy, etc.), vascular and neurotyre-tread medicines for internal reception, external means (, anti-inflammatory ointments), physical therapy (SMT, UVCh, a hydrocortisone electrophoresis). For the purpose of knocking over of pain the reflexotherapy can be applied. Manual therapy is effective in elimination of incomplete dislocations and stretching of a backbone for reduction of a compression of a cervical back. However in cervical department it has to be carried out with extra care and only the skilled manual therapist. At suspicion of a tumor physiotherapeutic methods and massage are contraindicated.
In the sharp period rest is shown to the patients having cervical radiculitis. For restriction of movements of cervical department carrying a collar of Shants can be recommended. In the period of a convalescence connect massage and LFK to treatment. Further regular jobs LFK and periodic courses of massage for strengthening of muscles of a backbone are recommended to patients. It is especially important to strengthen a muscular corset of necks after carrying a collar of Shants since during carrying a muscle to some extent atrophy.
Cervical radiculitis is treated surgically at a resistant compression of backs with lack of efficiency of conservative therapy. In such cases as the radiculitis reason the hernia nuclei pulposi or a tumor which removal considerably facilitates a condition of the patient usually acts. But it is necessary to remember that surgical intervention on cervical department of a backbone is always traumatic and can have complications. Concerning hernias depending on their sizes the open or endoscopic mikrodiskektomiya, a diskektomiya is carried out. Tactics of removal of a tumor of a backbone depends on its character and growth.
Forecast and prevention of cervical radiculitis
As a rule, the cervical radiculitis caused by osteochondrosis well will respond to treatment. But, as osteochondrosis remains, a radiculitis recurrence is in the future possible. And along with a cervical form there can be both lumbar, and chest radiculitis. The forecast is most adverse if cervical radiculitis is a consequence of a malignant tumor, especially at its germination to the vertebral canal and metastasis.
The best both primary, and secondary prevention of cervical radiculitis is the healthy nutrition and maintenance of the body in good physical shape. Reduction in a diet of salts and fats distances and slows down development of osteochondrosis. The mobile way of life, swimming, moderate physical activities with exercises for muscles of a back and a neck allows to strengthen the last so that they hold a spine column, without allowing vertebras to be displaced and sink.
Prevention of cervical radiculitis is especially urgent for persons with sedentary work (accountants, programmers, copywriters, jewelers, cashiers etc.). For the prevention long motionless and often the compelled position of the head and a neck breaks with performance of simple exercises for unloading of a waist, a back and a neck are recommended to them.