Osteochondrosis of the cervical spine : the symptoms
Disease / / August 12, 2017
- general concept of osteochondrosis
- main symptoms of cervical degenerative disc disease
- cervical myelopathy
- signs of radicular compression
- Cervical reflex syndromes
- syndrome anterior scalene muscle
- Syndrome pectoralis minor
- Rear sympathetic syndrome
osteochondrosis - a degenerative disease of the spine distoficheskoe, which is based on the defeat of the intervertebral discs.The development of degenerative diseases of the spine helps Microfracture prolonged, excessive static and dynamic load, genetic predisposition, advanced age.The most frequent localization of lesion - cervical and lumbar spine.This is due to their mobility and the greatest load.
general concept of osteochondrosis
Intervertebral disc eventually loses fluid and loses its shock-absorbing function.It becomes less resistant to physical stress.Fibrous ring which is disposed on the periphery of the disk gradually becomes thinner, it cracks.According to cracks formed the nucleus pulposus is sh
In the initial stages of the disease pain can be attributed to overstretching of the fibrous ring and the stimulation of the posterior longitudinal ligament.The pain may be localized or locally in the back neck, as well as in remote areas.With cervical osteochondrosis pain can be reflected in the neck, shoulder blade and interscapular region, shoulder girdle and arm.
pain is accompanied by segmental reflex spasm of muscles.This phenomenon has a protective character and stabilizes the spinal column poraschenny site.Over time, the muscle contraction becomes an independent source of pain.By moving towards the intervertebral foramen herniation compresses the adjacent nerve roots.Radicular pain is shooting, penetrating character, clearly localized along the nerve innervation.It is accompanied by a corresponding neurological manifestations:
- decrease sensitivity;
- loss of reflexes;
- muscle weakness.
disc degeneration disrupts the normal anatomic relationship between the components of the spinal column: discs, vertebrae, joints and ligaments.The gradual reduction of the intervertebral disc height results in a change of joint relations and the formation of the vertebral subluxations and dislocations.This fact points to the instability of the spine and reduces resistance to injury that can lead to an exacerbation of degenerative disc disease.
With age, the spine occurs restoring stability due to the formation of osteophytes, hypertrophy of articular processes, fibrosis drives, thickening of ligaments and joint capsule.The final stage of the pathological process is called spondylosis.Pain at that time subside.
main symptoms of cervical degenerative disc disease
At the level of compression of the cervical segments may be exposed nerve roots and their arteries, spinal cord and its vessels, the vertebral artery.Compression of the spinal cord is possible due to the back or rear intervertebral hernia osteophytes.By particularly susceptible people with a narrow spinal canal.When compression hernia symptoms of cervical degenerative disc disease develops quickly and the symptoms of the current liquor unit softer.
Clinically distinguish tumor compression and disc herniation of the spinal cord is very difficult.Osteochondrosis of the cervical spine appears spastic paresis foot sensitivity conduction disorders, pain and weakness in the hands.In some cases, signs of compression combined with signs of spinal cord ischemia substances resulting from compression of the spinal and radicular artery vessels.
may suddenly develop symptoms of anterior horn and ventral departments involving the pyramidal tract (anterior spinal artery blood flow).There anterior spinal syndrome: flaccid paresis of the hands, spastic paresis of the legs, sphincter disturbances.Sometimes symptoms develop gross violation of deep sensitivity in his hands.After 2-3 weeks of spinal stroke symptoms begin to regress.In terms of the pathological focus can be said about the severity of residual symptoms.
myelopathy is a chronic ischemia with cervical osteochondrosis.A major role in the development of this syndrome plays a compression of blood vessels.The most characteristic lesion of ventral divisions of the lateral columns and the anterior horns.Manifested spastikoatroficheskim paresis of the hands, spastic paresis of the legs, feet violation of deep sensitivity (classic triad).
In some patients there is a symptom Lhermitte: a sense of the passage of an electric discharge along the spine radiating pain in arms and legs moving head.Perhaps the development of amyotrophic lateral sclerosis in which there are no bulbar symptoms.
an important role in confirming mialopatii play MRI and CT scans, which reveal the compression of the envelope bag osteophytes and thickened yellow ligament.
signs of radicular compression
Since wear faster underlying disks, the corresponding segments of the developing spondylarthritis.Osteophytes narrow intervertebral foramen and squeeze the roots (at the lumbar level often are compressed disc herniation in the epidural space).When head movement sprawl injure the spine that causes the formation of edema, which further narrows the intervertebral foramen.Develop a reactive inflammatory reaction.
- C3-spine (below 2 cervical vertebra, there is rarely enough) - pain in the corresponding half of the neck, a feeling of swelling of the tongue, feeling of a lump in the throat;
- C4 spine - pain in the corresponding shoulder girdle, collarbone, atrophy of the trapezius muscle, lowering the tone of the neck muscles (irritation of the 3rd and 4th cervical roots increases the tone of the diaphragm, resulting in the displacement of the liver down and stenokardicheskie appearance of pain);
- C5 spine - pain in the neck and the outer surface of the shoulder, the deltoid muscle wasting;
- C6 root (one of the most common locations) - pain in the neck, shoulder blades, shoulder girdle on the outer surface of the shoulder, the radial surface of the forearm to apply 1 finger pareztezii in the hands, weakness of the biceps;
- C7 root - the pain spreads to the fingers 2-3, accompanied by paresthesias, weakness of the triceps;
- C8-back - the pain spreads to the ulnar surface of the forearm to the 5 fingers, accompanied by paresthesias.
Cervical reflex syndromes
vertebral syndrome manifested acute cervical pain (lumbago, Cervicalgia), rarely subacute or chronic pain.The main sources of pain - annulus, posterior longitudinal ligament, joint capsule, tense muscles.Torticollis is not as pronounced as the curvature of the spine in the lumbar level.
aching pain, radiating to the back of the head.Increases with movement or long-term stay in one position.On palpation determined by tenderness of the spinous processes and the capsule of the joints on the affected side (on the neck posteroexternal 3-4 cm lateral to the spinous processes).Characteristically involvement in the process, not only back, but the front of the spine and muscles (anterior scalene, etc..).
syndrome anterior scalene muscle
scalene muscle tension often arises in the cervical osteochondrosis.The muscle is determined by several side sternocleidomastoid muscle in the form of a busy strand, dense and larger in size compared to the healthy side.Due to the compression stress occurs supraclavicular vessels, which is accompanied by pain and swelling in his hand, sensory disturbances and motor activity (in the course of the ulnar nerve).Pain amplified in a horizontal position.
Syndrome pectoralis minor
Development Mechanism is similar to the previous one.Compression of the neurovascular bundle occurs between the muscle and the humerus (or coracoid process) under the enhanced exhaust arms.It is accompanied by pain in the chest, shoulder, arm.
Existing signs are often seen as a pain in the heart at VSD (acute attacks available, the effect of nitroglycerin or no sedation, increased symptoms during movement and palpation pain points).
Rear sympathetic syndrome
characteristic dystrophic, vasomotor disturbances, which arise as a result of stimulation of the sympathetic plexus of the vertebral artery.Plexus branches located in the tissues of the brain and skull.Clinically manifested by dizziness, tinnitus, visual disturbances, anxiety.
Compression of the vertebral arteries osteophytes emanating from the joints of the spine, combined with atherosclerotic lesions of these vessels is an important pathogenetic factor in the development of disease of the brain and spinal cord arteries.
Conclusion In most cases, pain in the arms and neck associated with cervical osteochondrosis.In some patients the pain caused by a herniated disc, others - osteophytes and joint osteoarthritis of the spine.Each of these options can lead to local or referred pain, radicular syndrome and myelopathy.In a study of patients with pain in the neck should be excluded, such as the pathology:
- spinal tumors;
- epidural abscess;
- subarachnoid hemorrhage;
- retropharyngeal abscess;
- bundle carotid artery;
- fracture of the cervical vertebrae.
12 Aug, 2017
12 Aug, 2017