Cervical – a degenerate and dystrophic disease of cervical department of a backbone. Includes changes of intervertebral disks, ossification of a forward longitudinal sheaf and emergence of bone growths on a lobby and the side surfaces of vertebras. Usually arises at advanced age. Long time asymptomatically can proceed. At decrease in height of disks and accession of a spondiloartroz it is shown by restriction of mobility of a neck, neck and nape pains. For specification of the diagnosis use a X-ray analysis, MPT, KT, a miyelografiya, an electromyography and other researches. Treatment is usually conservative.
Cervical – degenerate and dystrophic defeat of cervical department of a backbone. In most cases is a consequence of involute processes, arises at elderly people, can strike cervical, chest or lumbar department of a backbone. Initial signs of a spondilez are often noticeable on roentgenograms of patients at the age of 50 years and are more senior. More than 90% of persons are more senior than 65 years suffers spondilezy this or that degree of expressiveness. In certain cases the disease can develop at young people. Cervical – the most widespread kind of a spondilez. It is caused by anatomic and physiological features of cervical department of a backbone.
The neck is very mobile, at the same time the muscular corset is in the field developed more weakly, than in other departments of a spine column. When performing household and professional duties people quite often should keep long time not physiologic position of a neck that conducts to an overload of intervertebral disks, muscles and the copular device of a backbone. In most cases clinically shown cervical it is combined with other involute damages of a spine column: osteochondrosis and arthrosis of small joints of a backbone.
Anatomy and pathogenesis of a cervical spondilez
Cervical department – the most mobile department of a spine column. It consists of seven vertebras. All cervical vertebras, except for the first, have a body and shoots. At the first vertebra the body is absent. Between all cervical vertebras, except the first and second, there are elastic intervertebral disks performing function of shock-absorbers. Disks consist of a soft pulpozny kernel and a rigid fibrous ring which holds a kernel, without allowing it to be stuck out. Each vertebra, except the first, has articulate shoots which connect to articulate shoots of other vertebras, forming small facet joints. Besides, cervical vertebras have cross shoots with openings through which there pass vertebral arteries.
The backbone is strengthened by ligaments and muscles. One of large sheaves (a forward longitudinal sheaf) settles down on the forward surface of bodies of vertebras. At development of a cervical spondilez the fibrous ring partially loses the rigidity, and the pulpozny kernel which is under pressure is stuck out towards a forward longitudinal sheaf. In a ligament sites of ossification appear. Over time on a lobby and the side surfaces of vertebras bone growths are formed.
At preservation of height of an intervertebral disk cervical long time asymptomatically can proceed. If other degenerate and dystrophic processes join a spondilez (osteochondrosis, ), there is a mutual aggravation. Speed of progressing of pathological states increases. Gross anatomic violations are formed: decrease in height of intervertebral disks, restriction of mobility and anchylosis of small joints. The sdavleniye of nervous backs and a stenosis of the vertebral channel which are followed by development of neurologic symptomatology are possible.
Reasons of development of a cervical spondilez
In most cases age changes of metabolism, natural cell aging and tissues of a human body become the main reason for emergence of a cervical spondilez. Early development of a spondilez is promoted large single (for example, a fracture of cervical vertebras) or small repeated spine injuries in cervical department. The probability of early emergence and bystry progressing of a spondilez increases at exchange violations owing to which in cervical department of a spine column calcium salts are strenuously laid. Hormonal violations, overcoolings and chronic infections matter.
In separate group of the reasons it is worth carrying circumstances under which there is long not physiologic load of cervical department of a backbone. Refer to number of such circumstances violations of a bearing, scoliosis and strengthened cervical . Most often cervical develops at workers of brainwork, people who are carrying out professional duties in one static pose and the persons leading low-active lifestyle (quite often at patients with a cervical spondilez the combination of these factors is observed). The compelled position of the head during the work on the computer, behind a microscope or the typewriter creates excessive load of certain sites of cervical department of a backbone. And weak muscles are not able to compensate this loading.
Symptoms of a cervical spondilez
Patients with isolated spondilezy, not followed decrease in height of intervertebral disks, long time can not show any complaints. At accession of other diseases of a backbone and progressing of anatomic violations there are local dull aching or nagging pains which amplify after loading and weaken or disappear after long rest. The patient begins to spare a neck at the movements, tries to turn not only the head, but also the case.
The dizzinesses and headaches caused by deterioration in blood supply of a brain appear from behind a sdavleniye of vertebral arteries of an osteofitama over time. The combined compression of nerves and vessels can become the reason of violations of sight and hearing. Patients are disturbed by impossibility to concentrate a look, flashing of front sights, noise in ears and deterioration in hearing. In process of progressing of pathology the pain syndrome becomes longer and intensive. In the subsequent pains gain constant character and do not disappear even after a dream.
Because of pains and violation of normal anatomic ratios between separate elements of a backbone of a muscle of a neck are in constant tension. The spasm of cervical muscles promotes restriction of movements of cervical department and over time itself becomes the reason of pains in a neck. At further aggravation of pathological changes there can be neurologic symptoms caused by a sdavleniye of nervous backs (radiculitis) and a stenosis of the vertebral channel (a compression miyelopatiya). Violations of sensitivity of the top and lower extremities and the pains irradiating in a back, shoulders and hands are possible weakness of muscles.
Diagnostics of a cervical spondilez
Inspection of the patient suffering from a cervical spondilez includes definition of mobility of a neck, neurologic survey (check of reflexes, sensitivity and movements), and also additional researches. The most available method of tool diagnostics is the X-ray analysis of cervical department of a backbone. If necessary appoint KT of a spine column by means of which it is possible to consider all dense structures of a neck in details. For assessment of a condition of soft fabrics use MRT. Researches of nervous conductivity carry out by means of an electromyography.
Earlier usually applied a miyelografiya to identification of a stenosis of the vertebral channel – a X-ray contrast research at which contrast liquid or air were entered into the vertebral canal by means of a lyumbalny puncture, and then did a series of pictures. Now the given technique gradually loses the value because of emergence of KT and MPT. These methods allow to obtain the same data, but have no side effects and are much easier transferred by patients.
Treatment of a cervical spondilez
Treatment of a cervical spondilez is performed by vertebrolog, neurologists, orthopedists. Main objectives of treatment are elimination of a pain syndrome, improvement of local blood circulation, preservation of mobility of cervical department of a backbone, restoration of normal anatomic ratios between separate elements of a spine column and delay of degenerate and dystrophic processes in fabric of intervertebral disks.
To patients write out hondroprotektor and anti-inflammatory medicines. At an intensive pain syndrome apply analgetics, at the expressed spasms of cervical muscles – miorelaksant. Appoint physiotherapy (ultrasound, diadynamic currents, a medicinal electrophoresis with novocaine) and the LFK special complexes. The patient who should be long in the compelled situation, recommend to use an elastic collar for reduction of load of cervical department of a backbone.
In the absence of contraindications appoint manual therapy and the sparing massage. Rough massage receptions and the independent massage which is carried out by the nonspecialist are categorically contraindicated. At the sharp pains caused by a sdavleniye of nervous backs carry out blockade of the struck area (paravertebralny blockade and blockade of fasetchaty joints). Surgical treatment is required very seldom. Patients are directed to operation at a combination of several pathological processes (for example, a spondilez and a heavy spondiloartroz), inefficiencies of conservative treatment, and also in the presence of the progressing neurologic symptomatology testifying to a stenosis of the vertebral channel and a sdavleniya of nervous backs. Surgeries on a backbone are performed by vertebrolog or neurosurgeons.